Food-Induced Anaphylaxis: Data From the European Anaphylaxis Registry

Dölle-Bierke S, Höfer V, Francuzik W, Näher AF, Bilo MB, Cichocka-Jarosz E, Lopes de Oliveira LC, Fernandez-Rivas M, García BE, Hartmann K, Jappe U, Köhli A, Lange L, Maris I, Mustakov TB, Nemat K, Ott H, Papadopoulos NG, Pföhler C, Ruëff F, Sabouraud-Leclerc D, Spindler T, Stock P, Treudler R, Vogelberg C, Wagner N, Worm M (2023)

Publication Type: Journal article

Publication year: 2023

Journal

DOI: 10.1016/j.jaip.2023.03.026

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.

Additional Organisation(s)

Involved external institutions

Charité - Universitätsmedizin Berlin Germany (DE) Università Politecnica delle Marche (UNIVPM) / Marche Polytechnic University Italy (IT) Jagiellonian University Medical College Poland (PL) Federal University of São Paulo / Universidade Federal de São Paulo (UNIFESP) Brazil (BR) Universidad Complutense de Madrid (UCM) Spain (ES) Universidad de Navarra Spain (ES) Universitätsspital Basel Switzerland (CH) Forschungszentrum Borstel - Leibniz-Zentrum für Medizin und Biowissenschaften / Research Center Borstel - Leibniz-Center for Medicine and Biosciences Germany (DE) Universitäts-Kinderspital Zürich Switzerland (CH) St.-Marien-Hospital Bonn Germany (DE) Bon Secours Hospital Cork Ireland (IE) Medical University Sofia / Медицински университет Bulgaria (BG) Krankenhaus Dresden-Friedrichstadt, Städtisches Klinikum Germany (DE) Kinder- und Jugendkrankenhaus "Auf der Bult" Germany (DE) National and Kapodistrian University of Athens Greece (GR) Universitätsklinikum des Saarlandes (UKS) Germany (DE) Klinikum der Universität München Germany (DE) Centre hospitalier universitaire de Reims (CHU de Reims) France (FR) Fachklinik Prinzregent Luitpold Germany (DE) Altonaer Kinderkrankenhaus (AKK) Germany (DE) Universität Leipzig Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE)

How to cite

APA:

Dölle-Bierke, S., Höfer, V., Francuzik, W., Näher, A.F., Bilo, M.B., Cichocka-Jarosz, E.,... Worm, M. (2023). Food-Induced Anaphylaxis: Data From the European Anaphylaxis Registry. The Journal of Allergy and Clinical Immunology: In Practice. https://dx.doi.org/10.1016/j.jaip.2023.03.026

MLA:

Dölle-Bierke, Sabine, et al. "Food-Induced Anaphylaxis: Data From the European Anaphylaxis Registry." The Journal of Allergy and Clinical Immunology: In Practice (2023).

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