10.6084/m9.figshare.4818319.v1
Yanagida N.
Yanagida
N.
Sato S.
Sato
S.
Asaumi T.
Asaumi
T.
Ogura K.
Ogura
K.
Ebisawa M.
Ebisawa
M.
Supplementary Material for: Risk Factors for Severe Reactions during Double-Blind Placebo-Controlled Food Challenges
Karger Publishers
2017
Anaphylaxis
Children
Food hypersensitivity
Oral food challenge
Pediatric patients
2017-04-05 12:59:07
Dataset
https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Risk_Factors_for_Severe_Reactions_during_Double-Blind_Placebo-Controlled_Food_Challenges/4818319
<p><b><i>Background:</i></b> Severe anaphylactic symptoms can occur
during oral food challenges (OFCs). Thus, high-risk patients (e.g.,
patients with a history of anaphylaxis or high antigen-specific
immunoglobulin E [IgE] levels) must carefully undergo OFCs in hospitals.
We attempted to identify the risk factors for severe symptoms during
OFC testing among high-risk patients. <b><i>Methods:</i></b> We
retrospectively evaluated patients' characteristics and severe symptoms
that were experienced during a double-blind placebo-controlled food
challenge test performed before the patients underwent oral
immunotherapy between June 2008 and June 2012. Patients were ≥5 years
old and had an anaphylactic history or antigen-specific IgE (>30
kUA/L). Severe symptoms were defined using the grading of the Japanese
Anaphylaxis Guidelines, which are modified from the European Academy of
Allergology and Clinical Immunology Guidelines. <b><i>Results:</i></b>
We evaluated 393 cases with positive test results, including 98 cases
with severe symptoms. The most frequent severe symptoms were respiratory
(77%), gastrointestinal (28%), cardiovascular (27%), and neurological
(13%) symptoms. Multivariate analysis revealed that the significant
factors for a severe reaction were a history of anaphylaxis to the
causative food (adjusted odds ratio [OR]: 2.147, <i>p</i> = 0.003), older age (per 1 year increase, adjusted OR: 1.102, <i>p</i> = 0.044), and an egg OFC (adjusted OR: 0.433, <i>p = </i>0.003). <b><i>Conclusions:</i></b>
The risk factors for a severe reaction to OFCs were a history of an
anaphylactic reaction and older age. An egg OFC was associated with low
risk of severe symptoms during OFC. Therefore, OFCs for patients with
these risk factors should only be performed under specialist supervision
with access to rapid treatment and full resuscitation equipment.</p>