In new study to be published in the April 2010 issue of Pediatrics, Dr Susan Rudders of Children's Hospital Boston and colleagues reported on some 1200 children of around 6 years old, who were treated at two Boston hospitals for food-related allergic reactions between 2001 and 2006.
When they narrowed this group down to those with a severe food-induced anaphylactic reaction (52%), they found 44% of children received epinephrine and, of those 44%, 12% received more than one dose.
Before arriving at the hospital, 31% of children with a severe reaction received one dose of epinephrine and 3% received two doses. Once at the hospital, 20% received one dose of epinephrine and 1% received more than one dose.
The researchers believe that these results add weight to the recommendation that children at risk for severe food-related allergic reactions carry two doses of epinephrine.
However the researchers also noted that half of the children with food-induced anaphylactic reactions did not get epinephrine either before getting to the hospital or while at the hospital. At the hospital, the children received antihistamines, steroids, intravenous fluids and inhaled medicines more often than epinephrine, ‘despite the lack of evidence’ for their usefulness as a first-line treatment.
Moreover, fewer than half of the children with food-related allergic reactions left the hospital with a prescription for self-injectable epinephrine and only 22% were advised to see an allergist.
The researchers warn that food-related anaphylaxis continues to be inadequately treated and that, of the estimated 150 to 200 deaths each year from food-related anaphylactic reactions, delayed or lack of administration of epinephrine is often to blame.
Common offending foods in the children studied included peanuts, tree nuts, milk, shellfish, fish, and eggs. The researchers were surprised to find that fruits and vegetables - foods usually thought to be unlikely to cause an allergic reaction - were also triggers. Most of the children with severe reactions had typical symptoms - skin rash, itching, swelling, trouble swallowing and breathing, nausea and vomiting.
Courtesy of Reuters
First Published in March 2010
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