Data presented at the 2018 American Academy of Allergy, Asthma & Immunology and World Allergy Organization (AAAAI/WAO) Joint Congress found that reactions to peanut were the most common cause of anaphylaxis in pediatric intensive care units.

Data was collected from 2010 to 2015 and included 1,989 pediatric anaphylaxis admissions to North American PICUs. Researchers then determined how likely a child was to die from anaphylaxis, the most common triggers and which patients are most likely to suffer from anaphylaxis.

Common Causes. Food was the most common specified trigger of anaphylaxis. Reactions to peanut made up approximately 45% of food induced anaphylaxis cases, while tree nuts and seeds constituted about 19% and milk caused about 10% of the cases. Other common triggers included drug, blood products and venom.

Mortality and Morbidity. The burden of pediatric anaphylaxis was about 0.3% of all PICU admissions. The overall probability of death was 0.9% with 1% mortality. In addition, 19% of patients needed tracheal intubation. Peanut and dairy reactions were identified as the principal causes of death out of all food induced anaphylaxis.

Demographics. Anaphylaxis occurred more often in children ages 6 to 18 years-old compared to the overall PICU population and intubation was least common in children 2 to 5 years-old. Asian patients were disproportionately represented, although the mortality rate did not vary based on any demographic factors.

Other Factors. Admissions were most likely to occur during the fall and in the Northeast and Western regions of the United States.

“This study is important because it gives insight into the burden of anaphylaxis in pediatric patients on an international level,” said author Carla M. Davis, MD, FAAAAI. “The characteristics of anaphylaxis in children including epidemiology, morbidity and mortality tend to be underreported, even though the information could give insights into patterns and possible interventions.”

“The burden of pediatric anaphylaxis was higher than what we anticipated,” Davis added. “This means food induced anaphylaxis should be considered a serious medical condition and aggressively prevented and treated. Physicians should identify at risk patients and frequently review avoidance measures.”