Anaphylaxis admissions in pediatric intensive care units: follow up and risk of recurrence
Résumé
Abstract Background Data about the risk of anaphylaxis recurrence in children are lacking. We assessed anaphylaxis recurrence and medical follow-up in a cohort of children previously hospitalized in a French pediatric intensive care unit (PICU) for anaphylaxis. Methods We conducted a telephone survey of 166 children (?18y) hospitalized from 2003 to 2013. Results In all, 106 (64%) completed the survey [boys, 59%; mean age (SD):15.3y (5.5)]. The main index triggers were drugs (45%) and foods (37%). The mean duration follow-up was of 7.7y (SD: 2.4). Thirty-eight (36%) children experienced 399 new allergic reactions during a follow-up period of 282 patient-years (incidence rate: 1.4/100 patients/year; 95% CI: 0.64?2.04). Twelve children experienced 19 anaphylaxis reactions including five requiring PICU admission (anaphylaxis recurrence rate: 0.20/100 patients/year; 95%CI non-calculable). Food was the trigger for 79% of recurrent reactions, drugs for 8%. The food trigger was previously known in 83%, the same as the index trigger in 69%. Overall, 1.5% of the recurrent reactions were treated with adrenaline injection and 8% an emergency hospital admission. Patients with recurrence had more likely a history of food allergy (p