title: Risk factors for severe pediatric food anaphylaxis in Italy.
abstract: BACKGROUND
  Little is known about the cause of food-induced anaphylaxis in children or about the factors that might affect its clinical severity.
  
  
  OBJECTIVE
  The aim of this study was to investigate the cause of food-induced anaphylaxis in children in Italy and to identify factors that could influence the appearance of symptoms and the severity of anaphylaxis.
  
  
  METHODS
  One hundred and sixty-three children with anaphylaxis consecutively attending 29 outpatient allergy clinics throughout Italy were enrolled in this prospective study. Information about past anaphylaxis episodes was collected with a standardized questionnaire. Food sensitization was evaluated by skin-prick test.
  
  
  RESULTS
  A clinical history of asthma increased the risk of wheezing [odds ratio (OR) 2.2; 95% confidence interval (CI) 1.1-4.5] and respiratory arrest (OR 6.9; 95% CI 1.4-34.2). A clinical history of chronic/relapsing gastrointestinal symptoms increased the risk of vomiting (OR 2.1; 95% CI 0.9-4.3), hypotension (OR 7.9; 95% CI 1.9-32.0), and bradycardia/cardiac arrest (OR 9.2; 95% CI 0.9-91.3). The severity of present and previous episodes was similar only in patients with mild or moderate anaphylaxis. Peanut and egg were the most frequent causes of severe anaphylaxis.
  
  
  CONCLUSIONS
  A clinical history of asthma and chronic/relapsing gastrointestinal symptoms (probably linked to food allergy) may predict the development of respiratory and gastrointestinal symptoms and the severity of anaphylaxis.
authors.affiliation: Department of Pediatrics, San Camillo de Lellis Hospital, Rome, Italy. MI5660@mclink.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Calvani
authors.forename: Fabio
authors.initials: F
authors.lastname: Cardinale
authors.forename: Alberto
authors.initials: A
authors.lastname: Martelli
authors.forename: Antonella
authors.initials: A
authors.lastname: Muraro
authors.forename: Neri
authors.initials: N
authors.lastname: Pucci
authors.forename: Francesco
authors.initials: F
authors.lastname: Savino
authors.forename: Daniela
authors.initials: D
authors.lastname: Zappalà
authors.forename: Valentina
authors.initials: V
authors.lastname: Panetta
mesh_terms: D000293:Adolescent; D000707:Anaphylaxis / Q000453:epidemiology* / Q000276:immunology; D010367:Arachis / Q000009:adverse effects / Q000276:immunology; D001249:Asthma / Q000453:epidemiology* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004531:Eggs / Q000009:adverse effects; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors