Abstract
Background: Accidental allergic reactions (AAR) in children are
under-studied, especially with precise pediatrician-based exact
diagnoses and follow-ups. This study aimed to assess the prevalence and
risk factors for AAR in Japanese children with immediate-type food
allergies.
Methods: This single-center study included children with
immediate-type hen’s egg (HE), cow’s milk (CM), wheat, or peanut allergy
who had been followed-up regularly at a national center specialized for
allergy in Japan. Low-dose reactivity was defined as allergic reactions
to a low dose of ≤250, ≤102, ≤53, or ≤133 mg HE, CM, wheat, or peanut
protein, respectively. From January to December 2020, pediatricians
followed the AAR experience every 2–4 months. Risk factors for AAR were
analyzed using multiple logistic regression.
Results: Of the 1096 participants, 609, 457, 138, and 90 had
HE, CM, wheat, and peanut allergies, respectively. In this cohort, the
median age was 5.0 years, 39% had completely eliminated allergenic
food, and 24% had low-dose reactivity. The annual AAR rate was 0.130 in
all sub-cohorts. Moderate and severe symptoms occurred in 50% and
0.7%, respectively, of children who experienced AAR. Multiple logistic
regression revealed that low-dose reactivity was a significant risk
factor for AAR in the overall, HE, and CM cohorts, respectively
(p <0.001, p = 0.029 and 0.036).
Conclusion: In Japanese children with immediate-type food
allergies, the annualized rate of AAR was relatively low; however, half
of the participants with AAR had moderate to severe symptoms. Children,
especially those with low-dose reactivity, would require careful risk
management of AAR.
Keywords: allergic reactions; children; food allergies;
prevalence; pediatrics; risk factors