Anaphylaxis admissions in pediatric intensive care units: Follow‐up and risk of recurrence

Background Data about the risk of anaphylaxis recurrence in children are lacking. We assessed anaphylaxis recurrence and medical follow‐up in a cohort of children previously hospitalized in a French pediatric intensive care unit (PICU) for anaphylaxis. Methods We conducted a telephone survey of 166 children (≤18 years) hospitalized from 2003 to 2013. Results In all, 106 (64%) completed the survey (boys, 59%; mean age [SD]: 15.3 years [5.5]). The main index triggers were drugs (45%) and foods (37%). The mean duration follow‐up was of 7.7 years (SD: 2.4). Thirty‐eight (36%) children experienced 399 new allergic reactions during a follow‐up period of 282 patient‐years (incidence rate: 1.4/100 patients/y; 95% CI: 0.64‐2.04). Twelve children experienced 19 anaphylaxis reactions including five requiring PICU admission (anaphylaxis recurrence rate: 0.20/100 patients/y; 95% CI non‐calculable). Food was the trigger for 79% of recurrent reactions and drugs for 8%. The food trigger was previously known in 83%, the same as the index trigger in 69%. Overall, 1.5% of the recurrent reactions were treated with adrenaline injection and 8% an emergency hospital admission. Patients with recurrence had more likely a history of food allergy (P