High level of suspicion needed to identify children with egg-induced anaphylaxis  

A new study published in the Annals of Allergy, Asthma & Immunology has found that a high index of suspicion is needed to identify pediatric patients with egg-induced anaphylaxis. Children with egg-induced anaphylaxis were younger and presented with more vomiting, less throat tightness and less angioedema than those with anaphylaxis caused by other foods, and often lack a history of food-induced anaphylaxis.

Egg is the third most common food allergy in children and egg-induced anaphylaxis needs treating with adrenaline, but data on egg-induced anaphylaxis is sparse. This cross-sectional study based in Canada aimed to describe the clinical characteristics of egg-induced anaphylaxis along with management and outcomes.

Data on 3,713 children presenting with anaphylaxis in 13 emergency departments in Canada were assessed to compare anaphylaxis triggered by egg with other food triggers. 302 children with egg-induced anaphylaxis were included and the results showed:

• the mean age was 2.6 years (SD = 3.6)
• 55.3% were male
• only 39.4% had previously been diagnosed with an egg allergy
• pre-hospital epinephrine use was 32.1% (but this was not significantly lower than in other triggers of food induced anaphylaxis)  
• only 1.4% required hospital admission
• compared to other food triggers, patients with egg-induced anaphylaxis were significantly younger, had more vomiting, less throat tightness and less angioedema.

This is the largest published cohort of pediatric egg-induced anaphylaxis known to the authors. Taken together, the results show that high suspicion is crucial in identifying egg-induced anaphylaxis, given the younger age of patients and the frequent lack of history of food-induced anaphylaxis.

Read the study in the Annals of Allergy, Asthma & Immunology