1,974 results match your criteria Pediatrics Anaphylaxis


Anaphylaxis caused by artisanal honey in a child: a case report.

J Med Case Rep 2021 May 14;15(1):235. Epub 2021 May 14.

Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, Piacenza, Italy.

Background: Honey is a rare cause of food allergy, especially in children, but it can cause severe systemic allergic reactions. In the pediatric age group, only a few cases have been reported in the literature. Honey allergy may be caused by pollen content or bee-derived proteins. Read More

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Diagnosis of primary mast cell disorders in anaphylaxis: value of KIT D816V in peripheral blood.

J Allergy Clin Immunol Pract 2021 May 8. Epub 2021 May 8.

University of Antwerp, Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp Belgium; AZ Jan Palfijn Gent, Department of Immunology and Allergology, Ghent, Belgium.

Background: Anaphylaxis is frequent in patients suffering from primary mast cell disorders (PMCD). In patients without mastocytosis in the skin (MIS) and a baseline serum tryptase (bST) < 30 ng/mL, the diagnosis of PMCD is challenging. In these patients, detection of the KIT D816V mutation in peripheral blood (PB) has been suggested as screening tool for a PMCD. Read More

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Grass Pollen Allergy as an Anaphylaxis Co-factor during Peanut Oral Immunotherapy.

Ann Allergy Asthma Immunol 2021 May 7. Epub 2021 May 7.

Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, 4480 Oak St, Rm 2D, Vancouver, BC, V6H 3V4, Canada; Community Allergy Clinic, Unit 130, 3200 Shelbourne St, Victoria, BC, V8P 5G8, Canada. Electronic address:

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Adverse reactions to illicit drugs (marijuana, opioids, cocaine) and alcohol.

J Allergy Clin Immunol Pract 2021 May 6. Epub 2021 May 6.

Southdale Allergy and Asthma Clinic, LLC, Minneapolis, MN USA. Electronic address:

Drug allergy has been a research topic within the allergy field for decades. However, many drug reactions presumed to be of allergic nature, are not and originate from different mechanisms. Drug-induced reactions can affect numerous organ systems, present with a variety of symptoms, and have more than one mechanism of action. Read More

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Prevention and management of allergic reactions to food in child care centers and schools: Practice guidelines.

J Allergy Clin Immunol 2021 May;147(5):1561-1578

Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Food allergy management in child care centers and schools is a controversial topic, for which evidence-based guidance is needed. Following the Grading of Recommendations Assessment, Development, and Evaluation approach, we conducted systematic literature reviews of the anticipated health effects of selected interventions for managing food allergy in child care centers and schools; we compiled data about the costs, feasibility, acceptability, and effects on health equity of the selected interventions; and we developed the following conditional recommendations: we suggest that child care centers and schools implement allergy training and action plans; we suggest that they use epinephrine (adrenaline) to treat suspected anaphylaxis; we suggest that they stock unassigned epinephrine autoinjectors, instead of requiring students to supply their own personal autoinjectors to be stored on site for designated at-school use; and we suggest that they do not implement site-wide food prohibitions (eg, "nut-free" schools) or allergen-restricted zones (eg, "milk-free" tables), except in the special circumstances identified in this document. The recommendations are labeled "conditional" due to the low quality of available evidence. Read More

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Biomarkers of the severity of honeybee sting reactions and the severity and threshold of systemic adverse events during immunotherapy.

J Allergy Clin Immunol Pract 2021 May 4. Epub 2021 May 4.

University Hospital of Respiratory and Allergic Diseases, Golnik, Slovenia. Electronic address:

Background: A biomarker that could identify individuals at high risk for severe honeybee sting allergic reaction and/or systemic adverse events (SAEs) during venom immunotherapy (VIT) would improve the management of patients with honeybee (HB) venom allergy.

Objective: To identify biomarkers for risk of severe sting reactions or SAEs during VIT.

Methods: We recruited 332 patients undergoing honeybee VIT. Read More

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Preclinical development of plant-based oral immune modulatory therapy for haemophilia B.

Plant Biotechnol J 2021 May 5. Epub 2021 May 5.

Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Anti-drug antibody (ADA) formation is a major complication in treatment of the X-linked bleeding disorder haemophilia B (deficiency in coagulation factor IX, FIX). Current clinical immune tolerance protocols are often not effective due to complications such as anaphylactic reactions against FIX. Plant-based oral tolerance induction may address this problem, as illustrated by the recent first regulatory approval of orally delivered plant cells to treat peanut allergy. Read More

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A positive feedback loop reinforces the allergic immune response in human peanut allergy.

J Exp Med 2021 Jul 4;218(7). Epub 2021 May 4.

Sean N. Parker Center for Allergy & Asthma Research at Stanford University and Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford, CA.

Food allergies are a leading cause of anaphylaxis, and cellular mechanisms involving antigen presentation likely play key roles in their pathogenesis. However, little is known about the response of specific antigen-presenting cell (APC) subsets to food allergens in the setting of food allergies. Here, we show that in peanut-allergic humans, peanut allergen drives the differentiation of CD209+ monocyte-derived dendritic cells (DCs) and CD23+ (FcєRII) myeloid dendritic cells through the action of allergen-specific CD4+ T cells. Read More

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Global patterns in anaphylaxis due to specific foods: a systematic review.

J Allergy Clin Immunol 2021 Apr 30. Epub 2021 Apr 30.

National Heart & Lung Institute, Imperial College London, London, United Kingdom;; Department of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia. Electronic address:

Background: There are increasing global data relating to prevalence of food allergy and food-induced anaphylaxis, however this is often based on surrogate measures of sensitization rather than objective symptoms at food challenge. In terms of protecting food-allergic consumers from reactions, there has been no global survey assessing geographical differences in the proportion of anaphylaxis triggered by specific foods.

Objective: To identify common triggers for food-induced anaphylaxis, and how these vary from country to country. Read More

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The Effects of Patient Demographics on Outpatient Endoscopy Utilization in Children with Eosinophilic Esophagitis.

J Pediatr Gastroenterol Nutr 2021 Apr 28. Epub 2021 Apr 28.

Indiana University School of Medicine/Riley Hospital for Children, Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, 705 Riley Hospital Dr. ROC 4210, Indianapolis, IN 46202 Indiana University School of Medicine/Riley Hospital for Children, Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition Indiana University School of Medicine/Riley Hospital for Children, Department of Pediatrics, Division of Asthma and Allergy.

Objectives: Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus that requires esophagogastroduodenoscopy (EGD) for diagnosis and treatment monitoring. We aimed to identify frequency of endoscopic monitoring in children with EoE and observe the effect of age, race, socioeconomic factors, and atopy on the rate of endoscopy.

Methods: We queried the Pediatric Health Information System over a 15-year period for ambulatory EGDs in children with EoE. Read More

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Oral food challenge in IgE mediated food allergy in eastern Mediterranean children.

Allergol Immunopathol (Madr) 2021 1;49(3):185-192. Epub 2021 May 1.

Department of Pediatric Allergy, Hacettepe University Faculty of Medicine, Ankara, Turkey;

Background: The oral food challenge (OFC) in IgE mediated food allergy causes anxiety both in parents and in patients due to its inherent risks.

Objective: Documentation of the rate, spectrum, and predictors of positive reactions is instructive.

Methods: Children, who underwent OFC between January 1, 2017 and December 31, 2019 were analyzed. Read More

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Food-induced anaphylaxis in children up to 3-years-old - preliminary study.

Allergol Immunopathol (Madr) 2021 1;49(3):56-64. Epub 2021 May 1.

Department of Pediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.

Introduction And Objectives: The aim of this study was to determine the frequency of food-induced anaphylaxis, analyze the symptoms, and triggering factors in a group of youngest children. Also, the study aims to estimate the frequency of anaphylaxis episodes in children in the Kuyavian-Pomeranian Voivodeship region.

Methods: Retrospective analysis of medical records of 29 children aged 0-3 years that presented symptoms of food-induced anaphylaxis. Read More

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Blood pressure measurements could be reduced in number during the drug provocation test.

Clin Exp Allergy 2021 Apr 30. Epub 2021 Apr 30.

Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France.

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Genomic Spectrum and Phenotypic Heterogeneity of Human IL-21 Receptor Deficiency.

J Clin Immunol 2021 Apr 30. Epub 2021 Apr 30.

Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, NSW, 2010, Australia.

Biallelic inactivating mutations in IL21R causes a combined immunodeficiency that is often complicated by cryptosporidium infections. While eight IL-21R-deficient patients have been reported previously, the natural course, immune characteristics of disease, and response to hematopoietic stem cell transplantation (HSCT) remain to be comprehensively examined. In our study, we have collected clinical histories of 13 patients with IL-21R deficiency from eight families across seven centers worldwide, including five novel patients identified by exome or NGS panel sequencing. Read More

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Anaphylaxis to vaccination and polyethylene glycol (PEG): A perspective from the European Anaphylaxis Registry.

J Eur Acad Dermatol Venereol 2021 Apr 29. Epub 2021 Apr 29.

Division of Allergy and Immunology, Dpt. of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

The Covid-19 pandemic is currently one of the most important health challenges, and the recently approved vaccines can save millions of lives. However, the fact that anaphylaxis might occur after vaccination has raised much concern. Currently, Centers for Disease Control and Prevention (CDC) reported the rate of 2. Read More

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Nanoparticles Displaying Allergen and Siglec-8 Ligands Suppress IgE-FcεRI-Mediated Anaphylaxis and Desensitize Mast Cells to Subsequent Antigen Challenge.

J Immunol 2021 May 28;206(10):2290-2300. Epub 2021 Apr 28.

Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA

Siglec-8 is an inhibitory receptor expressed on eosinophils and mast cells. In this study, we took advantage of a novel Siglec-8 transgenic mouse model to assess the impact of modulating IgE-dependent mast cell degranulation and anaphylaxis using a liposomal platform to display an allergen with or without a synthetic glycan ligand for Siglec-8 (Sig8L). The hypothesis is that recruitment of Siglec-8 to the IgE-FcεRI receptor complex will inhibit allergen-induced mast cell degranulation. Read More

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Development and validation of a predictive model algorithm to identify anaphylaxis in adults with type 2 diabetes in U.S. administrative claims data.

Pharmacoepidemiol Drug Saf 2021 Apr 26. Epub 2021 Apr 26.

Sanofi, Paris, France.

Purpose: To use medical record adjudication and predictive modeling methods to develop and validate an algorithm to identify anaphylaxis among adults with type 2 diabetes (T2D) in administrative claims.

Methods: A conventional screening algorithm that prioritized sensitivity to identify potential anaphylaxis cases was developed and consisted of diagnosis codes for anaphylaxis or relevant signs and symptoms. This algorithm was applied to adults with T2D in the HealthCore Integrated Research Database (HIRD) from 2016 to 2018. Read More

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A severity grading system of food-induced acute allergic reactions to avoid delay of epinephrine administration.

Ann Allergy Asthma Immunol 2021 Apr 22. Epub 2021 Apr 22.

Department of Pediatrics and Allergy, Medical University of Lodz, Lodz, Poland, N. Copernicus Memorial Hospital, Lodz, Poland. Electronic address:

Background: Significant discrepancies among anaphylaxis severity scores may delay epinephrine administration.

Objective: The study aims to develop a transparent severity grading system of foodinduced acute allergic reactions with decision model for epinephrine use.

Methods: The natural course of 315 acute food-induced allergic reactions in children hospitalized at the Allergology Department between May 2016, and July 2019 due to follow-up treatment and/or allergy diagnostics, was evaluated. Read More

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The Importance of a Timely Second Dose of the 2021 COVID-19 mRNA Vaccine Depends on the Protection Afforded by a First Dose and Subsequent Risk of Anaphylaxis.

J Allergy Clin Immunol Pract 2021 Apr 20. Epub 2021 Apr 20.

Department of Pediatrics, Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado Denver School of Medicine, Denver, Colo.

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents our greatest hope to combat the devastating coronavirus disease 2019 (COVID-19) pandemic. Amid ongoing global vaccination efforts, rare cases of severe allergic reactions to COVID-19 mRNA vaccines have received significant attention. Although the exact nature of these reactions may be heterogeneous, various approaches exist to engage with patients, communities, public health departments, primary care providers, and other clinicians in a multidisciplinary approach to advance population health. Read More

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Small intestinal immunopathology and GI-associated antibody formation in hereditary alpha-tryptasemia.

J Allergy Clin Immunol 2021 Apr 15. Epub 2021 Apr 15.

Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA. Electronic address:

Background: Hereditary alpha-tryptasemia (HαT) is characterized by elevated basal serum tryptase (BST) due to increased copies of the TPSAB1 gene. Individuals with HαT frequently present with multisystem complaints, including anaphylaxis and seemingly functional gastrointestinal (GI) symptoms.

Objective: To determine the prevalence of HaT in an IBS cohort and associated immunological characteristics that may distinguish HaT from non-HaT patients. Read More

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Amoxicillin oral provocation challenge in a primary care clinic: a descriptive analysis.

CMAJ Open 2021 Apr-Jun;9(2):E394-E399. Epub 2021 Apr 16.

Department of Family Medicine (Gateman), McMaster University, Kitchener, Ont.; Department of Family Medicine (Gateman), Western University, Kitchener, Ont.; North Perth Family Health Team (Rumble), Listowel, Ont.; Departments of Pediatrics and Child Health, and Food and Human Nutritional Sciences (Protudjer), University of Manitoba; George & Fay Yee Centre for Healthcare Innovation (Protudjer); The Children's Hospital Research Institute of Manitoba (Protudjer), Winnipeg, Man.; Department of Medicine (Kim), Western University; Department of Medicine (Kim), McMaster University, Kitchener, Ont.

Background: Penicillin is the most frequently reported drug allergen; however, most of these allergies are not true allergies and do not justify the prescription of alternative, less effective and more expensive antibiotic drugs. We aimed to show that patients at low risk of amoxicillin allergy can safely and efficiently undergo oral provocation challenge (OPC) by their primary care physician.

Methods: In this descriptive analysis, we conducted a retrospective chart review of all primary care patients who had undergone OPC from November 2017 to October 2019 in the Amoxicillin Allergy Clinic at the North Perth Family Health Team, Listowel, Ontario. Read More

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Biologics and Novel Therapies for Food Allergy.

Immunol Allergy Clin North Am 2021 May 26;41(2):271-283. Epub 2021 Mar 26.

Division of Immunology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA. Electronic address:

Food allergy is a significant public health burden affecting around 10% of adults and 8% of children. Although the first peanut oral immunotherapy product received Food and Drug Administration approval in 2020, there is still an unmet need for more effective therapeutic options that minimize the risk of anaphylaxis, nutritional deficiencies, and patient's quality of life. Biologics are promising modalities, as they may improve compliance, target multiple food allergies, and treat other concomitant atopic diseases. Read More

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Mast Cell Activation During Suspected Perioperative Hypersensitivity: A Need for Paired Samples Analysis.

J Allergy Clin Immunol Pract 2021 Apr 20. Epub 2021 Apr 20.

Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology, Allergology, Rheumatology, Antwerp University Hospital, Antwerp, Belgium; AZ Jan Palfijn Gent, Department of Immunology and Allergology, Ghent, Belgium.

Background: Perioperative hypersensitivity (POH) reactions constitute a significant clinical and diagnostic challenge. A transient increase in serum tryptase during POH reflects mast cell activation (MCA) and helps to recognize an underlying hypersensitivity mechanism.

Objective: To determine the diagnostic performance of different tryptase decision thresholds based on single and paired measurements to document MCA in suspected POH. Read More

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Potential mechanisms of anaphylaxis to COVID-19 mRNA vaccines.

J Allergy Clin Immunol 2021 Apr 20. Epub 2021 Apr 20.

Department of Pediatrics, Columbia University Irving Medical Center, New York, NY.

Anaphylaxis to vaccines is historically a rare event. The coronavirus disease 2019 pandemic drove the need for rapid vaccine production applying a novel antigen delivery system: messenger RNA vaccines packaged in lipid nanoparticles. Unexpectedly, public vaccine administration led to a small number of severe allergic reactions, with resultant substantial public concern, especially within atopic individuals. Read More

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Wheat oral immunotherapy.

Curr Opin Allergy Clin Immunol 2021 Jun;21(3):269-277

Department of Pediatrics, NYU Grossman School of Medicine, Hassenfeld Childrens' Hospital.

Purpose Of Review: The prevalence of food allergy is increasing on a global scale, and therefore increased attention is being paid to specific food allergy epidemiology and management. There has been a large amount of progress made in the last decade on human trials of wheat oral immunotherapy (WOIT).

Recent Findings: To date, there has been one multicenter, double-blind, randomized controlled trial of WOIT, one randomized, noncontrolled trial of WOIT, and several smaller, nonrandomized clinical trials of WOIT. Read More

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Cardiac Arrest Following the Administration of Intravenous Diphenhydramine for Sedation to an Infant With Congenital Heart Disease.

J Pediatr Pharmacol Ther 2021 31;26(3):311-314. Epub 2021 Mar 31.

Diphenhydramine (Benadryl) is a first-generation antihistamine that is used primarily to treat allergic reactions including anaphylaxis, urticaria, and allergic rhinitis. Despite its availability as an over-the-counter medication, toxicity may occur with its use especially when administered in large doses or via the intravenous route. We present a 3-month-old infant with Trisomy 21 who suffered a cardiac arrest immediately following administration of a single 1. Read More

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Potential Efficacy of High-Dose Inhaled Salbutamol for the Treatment of Abdominal Pain During Oral Food Challenge.

J Allergy Clin Immunol Pract 2021 Apr 5. Epub 2021 Apr 5.

Department of Pediatrics, Section of Allergy and Clinical Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada; Department of Medicine, Section of Allergy and Clinical Immunology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada. Electronic address:

Background: Abdominal pain is a frequent symptom of IgE-mediated food allergy with limited therapeutic options. Visceral smooth muscle cell relaxation can be induced through beta-adrenergic stimulation.

Objective: To evaluate the efficacy of inhaled salbutamol empirically used to relieve abdominal pain caused by IgE-mediated allergic reactions at 1 center. Read More

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Vaccines and Allergic reactions: the past, the current COVID-19 pandemic, and future perspectives.

Allergy 2021 Apr 2. Epub 2021 Apr 2.

Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Vaccines are essential public health tools with a favorable safety profile and prophylactic effectiveness that have historically played significant roles in reducing infectious disease burden in populations, when the majority of individuals are vaccinated. The COVID-19 vaccines are expected to have similar positive impacts on health across the globe. While serious allergic reactions to vaccines are rare, their underlying mechanisms and implications for clinical management should be considered to provide individuals with the safest care possible. Read More

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