Anaphylaxis in Chinese Children: Different Clinical Profile Between Children with and without a History of Asthma/Recurrent Wheezing

Abstract

Purpose

Asthma and recurrent wheezing (RW) have been identified as risk factors for anaphylaxis; however, little is known about the characteristics of anaphylaxis in children with a history of asthma or RW in Chinese children.

Patients and Methods

This was a retrospective, observational chart review of children who were diagnosed with anaphylaxis in a tertiary children’s hospital between 2014 and 2021. Patients’ demographics, symptoms, triggers and presence of physician-diagnosed asthma/RW history were collected from medical charts.

Results

A total of 399 anaphylactic reactions in 264 patients were analyzed; 119 patients (45.1%) had a history of asthma/RW. Food was the most common cause (85.5%, 341/399). Compared with patients without a history of asthma/RW, buckwheat-induced anaphylaxis was significantly more common in the asthma/RW group (9.4% vs 0.5%, p < 0.001), patients with a history of asthma/RW had higher rates of oropharyngeal symptoms (17.3% vs 8.6%, p = 0.011) and wheezing (34.5% vs 15.9%, p < 0.001). Ninety-one reactions (22.8%, 91/399) presented as severe anaphylaxis, but no difference existed between asthma/RW and non-asthma/RW groups. Children with a history of asthma/RW were more likely to receive inhaled β agonists than children without a history of asthma/RW (11.8% vs 2.5%, p = 0.003). A larger proportion of children without asthma/RW history were treated with epinephrine (11.7%) than children with asthma/RW history (6.9%).

Conclusion

Our finding revealed that different clinical profiles of anaphylaxis in children with and without a history of asthma/RW. Our study did not find that children with a history of asthma/RW have more severe anaphylactic reactions compared with children without asthma/RW. Buckwheat-induced anaphylaxis was more common in the asthma/RW group, wheezing and oropharyngeal symptoms affected a higher proportion of the asthma/RW group.

Keywords:

• anaphylaxis
• asthma
• epinephrine
• wheezing
• children

Data Sharing Statement

The data and materials are available from the corresponding authors based on reasonable requirement.

Consent for Publication

All authors have approved the manuscript and agree with its submission to Journal of Asthma and Allergy.

Acknowledgments

We appreciated all the patients and investigators who participated in this study.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported by Beijing Hospitals Authority Youth Programme (code: QML20201203) and Respiratory Research Project of National Clinical Research Center for Respiratory Diseases (code:HXZX-20210203, HXZX-20210204, HXZX-202107). The Special Fund of the Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority (XTCX201818).