Food-Induced Anaphylaxis: Data From the European Anaphylaxis Registry

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Sabine Dölle-Bierke - , Charité – Universitätsmedizin Berlin (Author)
  • Veronika Höfer - , Charité – Universitätsmedizin Berlin (Author)
  • Wojciech Francuzik - , Charité – Universitätsmedizin Berlin (Author)
  • Anatol Fiete Näher - , Charité – Universitätsmedizin Berlin, Robert Koch-Institut (Author)
  • Maria Beatrice Bilo - , Marche Polytechnic University (Author)
  • Ewa Cichocka-Jarosz - , Jagiellonian University in Kraków (Author)
  • Lucila C. Lopes de Oliveira - , Federal University of São Paulo (Author)
  • Montserrat Fernandez-Rivas - , Complutense University (Author)
  • Blanca E. García - , University of Navarra (Author)
  • Karin Hartmann - , University of Basel (Author)
  • Uta Jappe - , Research Center Borstel - Leibniz Lung Center, University of Lübeck (Author)
  • Alice Köhli - , University of Zurich, Children's Hospital Lucerne (Author)
  • Lars Lange - , GFO Hospitals Bonn (Author)
  • Ioana Maris - , Bon Secours Hospital, University College Cork (Author)
  • Tihomir Bogdanov Mustakov - , Medical University Sofia (Author)
  • Katja Nemat - , Municipal Hospital Dresden, TUD Dresden University of Technology (Author)
  • Hagen Ott - , Children's Hospital Auf der Bult (Author)
  • Nikolaos G. Papadopoulos - , National and Kapodistrian University of Athens (Author)
  • Claudia Pföhler - , Saarland University (Author)
  • Franziska Ruëff - , Ludwig Maximilian University of Munich (Author)
  • Dominique Sabouraud-Leclerc - , CHU de Reims (Author)
  • Thomas Spindler - , Fachklinik Prinzregent Luitpold (Author)
  • Philippe Stock - , University of Hamburg (Author)
  • Regina Treudler - , Leipzig University (Author)
  • Christian Vogelberg - , Department of Paediatrics, University Hospital Carl Gustav Carus Dresden (Author)
  • Nicola Wagner - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Margitta Worm - , Charité – Universitätsmedizin Berlin (Author)

Abstract

Background: Food is one of the most common elicitors of anaphylaxis, with an increasing incidence over recent years. Objectives: To characterize elicitor-specific phenotypes and identify factors enhancing the risk or severity of food-induced anaphylaxis (FIA). Methods: We analyzed data from the European Anaphylaxis Registry applying an age- and sex-matched analysis of associations (Cramer's V) for single food triggers and calculated odds ratios (ORs) for severe FIA. Results: We identified 3,427 cases of confirmed FIA showing an age-dependent elicitor ranking (for children: peanut, cow's milk, cashew, and hen's egg; and for adults: wheat flour, shellfish, hazelnut, and soy). The age- and sex-matched analysis revealed defined symptom patterns for wheat and cashew. Wheat-induced anaphylaxis was more frequently associated with cardiovascular symptoms (75.7%; Cramer's V = 0.28) and cashew-induced anaphylaxis with gastrointestinal symptoms (73.9%; Cramer's V = 0.20). Furthermore, concomitant atopic dermatitis was slightly associated with anaphylaxis to hen's egg (Cramer's V = 0.19) and exercise was strongly associated with anaphylaxis to wheat (Cramer's V = 0.56). Additional factors influencing the severity were alcohol intake in wheat anaphylaxis (OR = 3.23; CI, 1.31-8.83) and exercise in peanut anaphylaxis (OR = 1.78; CI, 1.09-2.95). Conclusions: Our data show that FIA is age-dependent. In adults, the range of elicitors inducing FIA is broader. For some elicitors, the severity of FIA seems to be related to the elicitor. These data require confirmation in future studies considering a clear differentiation between augmentation and risk factors in FIA.

Details

Original languageEnglish
Pages (from-to)2069-2079.e7
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume11
Issue number7
Publication statusPublished - Jul 2023
Peer-reviewedYes

External IDs

PubMed 36990430

Keywords

ASJC Scopus subject areas

Keywords

  • Cashew, Food anaphylaxis, Hazelnut, Peanut, Phenotype, Risk factors, Shellfish, Wheat, Allergens, Humans, Anaphylaxis/diagnosis, Flour, Triticum, Animals, Cattle, Chickens, Female, Registries, Arachis, Food Hypersensitivity/diagnosis

Library keywords