BackgroundThe epidemiology and early-life risk factors of foodinducedanaphylaxis (“anaphylaxis”) in adolescence areincompletely understood.ObjectiveTo study aspects and early-life risk factors of foodinducedanaphylaxis amongst adolescents.MethodsParent-reported questionnaire data from 2-3months, and 1,2 and 16 years from a large birth cohort were used(N=3153). Immunoglobulin E to 14 common allergens wereanalysed at 4 (n=2283) and 16 years (n=2510). In a subset of371 adolescents, 15 additional food allergen extracts orcomponents were analysed at 16 years. Data on dispensedadrenaline autoinjectors and inhaled steroids were extractedfrom a national register. Severity of food reactions andasthma were defined. The incidence of anaphylaxis wasanalysed in association with early-life risk factors.ResultsIn the 12 months prior to the study, 8.5% of adolescentsreacted to food and 0.8% had anaphylaxis; the annualincidence of the latter was 761/100,000 person years.Only one-third of adolescents when experiencing anaphylaxishad contacted healthcare. Restricting analysesto these adolescents yielded an annual incidence of 240/100,000 person years. In the 24-months prior to thestudy, adrenaline autoinjectors were dispensed for 67%of those with reported symptoms defined by us as anaphylaxisaccording to international guidelines. Thestrongest early-life risk factors for anaphylaxis includedsensitisation to foods at 4 years (OR=20.9, 95%CI 6.8-64) and food reactions (OR=17.7, 95%CI 6.91-45.2)between 1-2 years.ConclusionAnaphylaxis in adolescence is more common than previouslyreported in the literature. Early-life sensitisationand reactions to foods increase anaphylaxis risk in adolescenceby more than 15-fold.
展开▼
