One Epinephrine Dose May Not Suffice for Children With Multiple Food Allergies

One Epinephrine Dose May Not Suffice for Children With Multiple Food Allergies

from Medscape
NEW YORK (Reuters Health) Jul 09 – Nearly one in five food-induced anaphylactic reactions that occur in children with multiple food allergies will require two or more doses of epinephrine, new research suggests.

As reported in an upcoming issue of the Journal of Allergy and Clinical Immunology, Dr. Kirsi M. Jarvinen, from Mount Sinai School of Medicine in New York, and colleagues evaluated epinephrine usage in children with food allergies by surveying the families of 413 patients.

Overall, 78 children (median age = 4.5 years) were given epinephrine for a total of 95 reactions, the report indicates. Over 75% of these reactions involved peanut, tree nut, or cow’s milk allergies.

Twelve (13%) of the reactions required two doses of epinephrine and an additional 6 (6%) required three doses, the researchers found.

Asthma was identified as a predictor of receiving multiple epinephrine doses, whereas the amount of food ingested and the delay in initial epinephrine treatment seemed to have no effect.

“Our survey performed in a highly selected patient population indicates that a significant number of respondents received a second dose of epinephrine,” the authors conclude. “Prospective studies are needed to identify risk factors for severe anaphylaxis and to establish rational guidelines for prescribing multiple epinephrine autoinjectors for children with food allergy.”

J Allergy Clin Immunol 2008.

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