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van der Aa LE, van Egmond IS, van der Sluijs M, den Otter AAS, Bosmans NHM, van Beek SE, Hartman A, Guchelaar NAD, van Daele PLA, van Maaren MS, van Hagen PM, Hermans MAW, Rombach SM. COVID-19 Incidence and Disease Course Among Patients at an Allergy Department. Ther Adv Allergy Rhinol 2023; 14:27534030231172391. [PMID: 37207194 PMCID: PMC10189845 DOI: 10.1177/27534030231172391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/12/2023] [Indexed: 05/21/2023]
Abstract
Background Since the coronavirus pandemic in 2020, there is not much reported about the disease course of COVID-19 in patients with allergic diseases. Objectives The aim of this study was to investigate the cumulative incidence and severity of COVID-19 among patients from the allergy department compared with the general Dutch population and people from their household. Design We conducted a comparative longitudinal cohort study. Methods In this study patients of the allergy department were included with their household members as a control group. Data from the beginning of the pandemic were systematically obtained through questionnaires by telephonic interviews and retrieved from electronic patient files between October 15, 2020 and January 29, 2021. Main outcomes were confirmed SARS-CoV-2 infection, disease duration, hospitalization, intensive care admission, and mortality. Questions regarding applied social distancing measures were inventoried as well. Results Three hundred and eighty nine patients (median age 39.1 (18.7-84.7) years, 69.9% female) and 441 household members (median age 42.0 (18.0-91.5), 44.1% female) were included. The cumulative COVID-19 incidence in patients was higher compared with the general population (10.5% vs 5.6%, P < .001). In total, 41 (10.5%) patients attending the allergy clinic compared to 38 (8.6%) household members were infected with SARS-CoV-2 (P = .407). Median disease duration was 11.0 (0.0-61.0) days in patients compared to 10.5(1.0-232.0) days in household members (P = .996). Conclusion The cumulative COVID-19 incidence in patients from the allergy cohort was higher compared with the general Dutch population, but similar compared with household members. There was no difference in symptoms, disease duration, or hospitalization rate between the allergy cohort and their household members.
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Affiliation(s)
| | | | | | | | | | | | | | - Niels A D Guchelaar
- Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Paul L A van Daele
- Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Laboratory of Medical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Maurits S van Maaren
- Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - P Martin van Hagen
- Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Laboratory of Medical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Saskia M Rombach
- Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Terlouw S, van Boven FE, Borsboom-van Zonneveld M, de Graaf-in ‘t Veld C, van Splunter ME, van Daele PLA, van Maaren MS, Schreurs MWJ, de Jong NW. Homemade Food Allergen Extracts for Use in Skin Prick Tests in the Diagnosis of IgE-Mediated Food Allergy: A Good Alternative in the Absence of Commercially Available Extracts? Nutrients 2022; 14:nu14030475. [PMID: 35276832 PMCID: PMC8839075 DOI: 10.3390/nu14030475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: The skin prick test (SPT) is the first step in the diagnosis of an immunoglobulin E (IgE)-mediated food allergy. The availability of commercial food allergen extracts is very limited, resulting in a need for alternative extraction methods of food allergens. The objective of this study was to compare the SPT results of homemade food allergen extracts with commercially available extracts. Methods: Adult patients with a suspected food allergy were included. Food allergen-specific symptoms were scored using a questionnaire. SPTs were performed with homemade and commercially available extracts (ALK-Abelló, Kopenhagen, Denmark) from almond, apple, hazelnut, peach, peanut, and walnut. Serum-specific IgE was measured with ISAC or ImmunoCAP™. Intra-class correlation coefficients (ICC) between the SPT results of both extract methods were calculated. The proportion of agreement with food allergen-specific symptoms was analyzed. Results: Fifty-four patients (mean age 36; range 19–69 years; female/male: 42/12) were included. The intra-class correlation coefficient (ICC) between the SPT results of both extract methods were strong for hazelnut 0.79 (n = 44) and walnut 0.78 (n = 31), moderate for apple 0.74 (n = 21) and peanut 0.66 (n = 28), and weak for almond 0.36 (n = 27) and peach 0.17 (n = 23). The proportion of agreement between SPT results and food allergen-specific symptoms was comparable for homemade and commercially available extracts, except for peach; 0.77 versus 0.36, respectively. Conclusion: In the diagnostic procedures to identify an IgE-mediated food allergy, homemade extracts from hazelnut and walnut appear to be a good alternative in the absence of commercially available food allergen extracts.
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Affiliation(s)
- Severina Terlouw
- Department of Allergology, Albert Schweitzer Hospital, 3331 LZ Zwijndrecht, The Netherlands; (M.B.-v.Z.); (C.d.G.-i.‘t.V.)
- Internal Medicine, Allergology & Clinical Immunology, Erasmus MC, University Medical Centre, 3015 GD Rotterdam, The Netherlands; (F.E.v.B.); (M.E.v.S.); (P.L.A.v.D.); (M.S.v.M.); (N.W.d.J.)
- Correspondence: ; Tel.: +31-640149222
| | - Frank E. van Boven
- Internal Medicine, Allergology & Clinical Immunology, Erasmus MC, University Medical Centre, 3015 GD Rotterdam, The Netherlands; (F.E.v.B.); (M.E.v.S.); (P.L.A.v.D.); (M.S.v.M.); (N.W.d.J.)
| | - Monika Borsboom-van Zonneveld
- Department of Allergology, Albert Schweitzer Hospital, 3331 LZ Zwijndrecht, The Netherlands; (M.B.-v.Z.); (C.d.G.-i.‘t.V.)
| | - Catharina de Graaf-in ‘t Veld
- Department of Allergology, Albert Schweitzer Hospital, 3331 LZ Zwijndrecht, The Netherlands; (M.B.-v.Z.); (C.d.G.-i.‘t.V.)
| | - Marloes E. van Splunter
- Internal Medicine, Allergology & Clinical Immunology, Erasmus MC, University Medical Centre, 3015 GD Rotterdam, The Netherlands; (F.E.v.B.); (M.E.v.S.); (P.L.A.v.D.); (M.S.v.M.); (N.W.d.J.)
| | - Paul L. A. van Daele
- Internal Medicine, Allergology & Clinical Immunology, Erasmus MC, University Medical Centre, 3015 GD Rotterdam, The Netherlands; (F.E.v.B.); (M.E.v.S.); (P.L.A.v.D.); (M.S.v.M.); (N.W.d.J.)
| | - Maurits S. van Maaren
- Internal Medicine, Allergology & Clinical Immunology, Erasmus MC, University Medical Centre, 3015 GD Rotterdam, The Netherlands; (F.E.v.B.); (M.E.v.S.); (P.L.A.v.D.); (M.S.v.M.); (N.W.d.J.)
| | - Marco W. J. Schreurs
- Laboratory Medical Immunology, Department of Immunology, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands;
| | - Nicolette W. de Jong
- Internal Medicine, Allergology & Clinical Immunology, Erasmus MC, University Medical Centre, 3015 GD Rotterdam, The Netherlands; (F.E.v.B.); (M.E.v.S.); (P.L.A.v.D.); (M.S.v.M.); (N.W.d.J.)
- Department of Pediatric Allergology, Sophia Children Hospital, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands
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van de Ven AAJM, Oude Elberink JNG, Nederhoed V, van Maaren MS, Tupker R, Röckmann-Helmbach H. Causes of perioperative hypersensitivity reactions in the Netherlands from 2002 to 2014. Clin Exp Allergy 2021; 52:192-196. [PMID: 34741764 PMCID: PMC9298996 DOI: 10.1111/cea.14042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 10/31/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Annick A J M van de Ven
- Department of Internal Medicine and Allergology, University Medical Centre Groningen, Groningen, the Netherlands
| | - Joanne N G Oude Elberink
- Department of Internal Medicine and Allergology, University Medical Centre Groningen, Groningen, the Netherlands
| | - Vera Nederhoed
- Department of Dermatology and Allergology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Maurits S van Maaren
- Department of Allergology, Erasmus Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Ron Tupker
- Department of Dermatology, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Heike Röckmann-Helmbach
- Department of Dermatology and Allergology, University Medical Centre Utrecht, Utrecht, the Netherlands
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Bansie RD, Karim AF, van Maaren MS, Hermans MA, van Daele PLA, Gerth van Wijk R, Rombach SM. Assessment of immediate and non-immediate hypersensitivity contrast reactions by skin tests and provocation tests: A review. Int J Immunopathol Pharmacol 2021; 35:20587384211015061. [PMID: 34053316 PMCID: PMC8170298 DOI: 10.1177/20587384211015061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Allergic and nonallergic hypersensitivity reactions to iodinated contrast media (ICM) and gadolinium-based contrast media are classified as immediate or non-immediate hypersensitivity reactions (IHR and NIHR), respectively. Skin tests and provocation tests are recommended for the evaluation of hypersensitivity reactions to contrast agents; however provocations are not common in clinical practice. METHODS A MEDLINE search was conducted to investigate studies comprising both skin tests and provocation tests that evaluated hypersensitivity reactions to ICM. RESULTS Nineteen studies were identified that reported on skin tests, followed by provocations. In the case of IHR to ICM, 65/69 (94%) patients with a positive skin test for the culprit media tolerated a challenge with a skin-test-negative alternative ICM. In IHR to ICM with a negative skin test for the culprit media, provocations were positive in 3.2%-9.1% patients. In the case of a NIHR to ICM with a positive skin test, provocation with a skin-test-negative agent was tolerated in 75/105 (71%) of cases. In NIHR with a negative skin test for the culprit agent, re-exposure to the culprit or an alternative was positive in 0%-34.6% patients. Provocations with the same ICM in skin test positive patients with IHR or NIHR were positive for a majority of the patients, although such provocation tests were rarely performed. Data on hypersensitivity reactions, skin tests and provocations with gadolinium-based contrast media were limited; however, they exhibited a pattern similar to that observed in ICM. CONCLUSION In both ICM and gadolinium-based contrast media, the risk of an immediate repeat reaction is low when skin tests are negative. In contrast, a provocation with a skin-test-positive contrast medium showed a high risk of an immediate repeat hypersensitivity reaction. Therefore, a thorough medical history is necessary, followed by skin tests. A provocation is recommended, for diagnostic work-up, when the diagnosis is uncertain.
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Affiliation(s)
- Rakesh D Bansie
- Department of Internal Medicine, Section Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, Zuid-Holland, the Netherlands.,Department of Internal Medicine, Academic Hospital Paramaribo, Paramaribo, Suriname
| | - A Faiz Karim
- Department of Internal Medicine, Section Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, Zuid-Holland, the Netherlands.,Department of Internal Medicine, Section Allergy and Clinical Immunology, Gouda Groene Hart Ziekenhuis, Zuid-Holland, the Netherlands
| | - Maurits S van Maaren
- Department of Internal Medicine, Section Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, Zuid-Holland, the Netherlands
| | - Maud Aw Hermans
- Department of Internal Medicine, Section Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, Zuid-Holland, the Netherlands
| | - Paul LA van Daele
- Department of Internal Medicine, Section Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, Zuid-Holland, the Netherlands
| | - Roy Gerth van Wijk
- Department of Internal Medicine, Section Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, Zuid-Holland, the Netherlands
| | - Saskia M Rombach
- Department of Internal Medicine, Section Allergy and Clinical Immunology, Erasmus Medical Center, Rotterdam, Zuid-Holland, the Netherlands
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Buters TP, van der Velden WAC, Abdisalaam I, van Maaren MS, van Doorn MBA. Effectiveness and tolerability of personalized omalizumab treatment in patients with chronic inducible urticaria. J Allergy Clin Immunol Pract 2021; 9:3227-3229. [PMID: 33915307 DOI: 10.1016/j.jaip.2021.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Thomas P Buters
- Department of Dermatology, Urticaria Center of Reference and Excellence, Erasmus Medical Center, Rotterdam, the Netherlands; Centre for Human Drug Research, Leiden, the Netherlands
| | - Willemijn A C van der Velden
- Department of Dermatology, Urticaria Center of Reference and Excellence, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ismahaan Abdisalaam
- Department of Dermatology, Urticaria Center of Reference and Excellence, Erasmus Medical Center, Rotterdam, the Netherlands; Centre for Human Drug Research, Leiden, the Netherlands
| | - Maurits S van Maaren
- Department of Allergology, Urticaria Center of Reference and Excellence, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Martijn B A van Doorn
- Department of Dermatology, Urticaria Center of Reference and Excellence, Erasmus Medical Center, Rotterdam, the Netherlands; Centre for Human Drug Research, Leiden, the Netherlands.
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Guchelaar NAD, van Laar JAM, Hermans MAW, van der Houwen TB, Atmaca S, van Maaren MS, Brkic Z, van Daele PLA, Dalm VASH, van Hagen PM, Rombach SM. Characteristics of COVID-19 infection and antibody formation in patients known at a tertiary immunology department. J Transl Autoimmun 2021; 4:100084. [PMID: 33532723 PMCID: PMC7844355 DOI: 10.1016/j.jtauto.2021.100084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/13/2021] [Accepted: 01/23/2021] [Indexed: 01/08/2023] Open
Abstract
Background Knowledge about COVID-19 infections is expanding, although knowledge about the disease course and antibody formation in patients with an auto-immune disease or immunodeficiency is not fully unraveled yet. It could be hypothesized that immunodeficient patients, due to immunosuppressive drugs or their disease, have a more severe disease course due to their immunocompromised state. However, it could also be hypothesized that some of the immunosuppressive drugs protect against a hyperinflammatory state. Methods We collected data on the incidence of COVID-19, disease course and SARS-CoV-2 antibody formation in COVID-19 positive patients in a cohort of patients (n = 4497) known at the Clinical Immunology outpatient clinic in a tertiary care hospital in the Netherlands. Results In the first six months of the pandemic, 16 patients were identified with COVID-19, 14 by nasal swab PCR, and 2 patients by SARS-CoV-2 antibodies. Eight patients were admitted to the hospital. SARS-CoV-2 antibodies were measured in 8 patients and were detectable in all, including one patient on B-cell ablative therapy and one patient with Common Variable Immunodeficiency Disorder. Conclusion This study indicates that the disease course differs among immunocompromised patients, independently of (dis)continuation of immunosuppressive drugs. Antibody production for SARS-CoV-2 in immunocompromised patients was shown. More research needs to be conducted to confirm these observations and guidelines regarding (dis)continuation of immunosuppressive drugs in COVID-19 positive immunocompromised patients should be developed. The disease course of COVID-19 largely differs among immunocompromised individuals. Antibody production against SARS-CoV-2 is noticed in immunocompromised patients. Further recommendations on (dis)continuation on immunosuppressive drugs during a COVID-19 infection are needed.
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Affiliation(s)
- Niels A D Guchelaar
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Jan A M van Laar
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Maud A W Hermans
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Tim B van der Houwen
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Sibel Atmaca
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Maurits S van Maaren
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Zana Brkic
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Paul L A van Daele
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Virgil A S H Dalm
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - P Martin van Hagen
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Saskia M Rombach
- Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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Niemeyer-van der Kolk T, van Maaren MS, van Doorn MBA. Personalized omalizumab treatment improves clinical benefit in patients with chronic spontaneous urticaria. J Allergy Clin Immunol 2018; 142:1992-1994. [PMID: 30144475 DOI: 10.1016/j.jaci.2018.07.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/26/2018] [Accepted: 07/31/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Tessa Niemeyer-van der Kolk
- Centre for Human Drug Research, Leiden, The Netherlands; Department of Dermatology Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Maurits S van Maaren
- Department of Internal Medicine, Allergology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Martijn B A van Doorn
- Centre for Human Drug Research, Leiden, The Netherlands; Department of Dermatology Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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van der Valk JPM, Berends I, Gerth van Wijk R, Arends NJT, van Maaren MS, de Groot H, Wichers HJ, Emons JAM, Dubois AEJ, de Jong NW. Small percentage of anaphylactic reactions treated with epinephrine during food challenges in Dutch children. Ann Allergy Asthma Immunol 2017; 120:300-303. [PMID: 29017902 DOI: 10.1016/j.anai.2017.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/11/2017] [Accepted: 08/23/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Severe allergic reactions, including anaphylaxis, occur during oral food challenges (OFCs) and the first-line treatment of anaphylaxis is epinephrine. OBJECTIVE To evaluate the percentage of anaphylactic reactions treated with epinephrine during OFCs and to identify associated factors for the administration of epinephrine. METHODS Children who underwent an OFC with peanut, hazelnut, cow's milk, hen's egg, or cashew nut from 2005 through 2015 in the Netherlands were evaluated. Children with reactions meeting the criteria for anaphylaxis according to the European Academy of Allergy and Clinical Immunology guidelines for food allergy and anaphylaxis were included. Children with an anaphylactic reaction treated with vs without epinephrine were compared. Possible factors associated with the administration of epinephrine, such as age, sex, symptoms consistent with asthma, history of an allergic reaction to the tested allergen, and symptom types during the anaphylactic reaction, were evaluated using logistic regression analysis. RESULTS Eighty-three children in clinical and research settings (43% boys; median age, 7 years; range, 1-17) who met the criteria for anaphylaxis were included in this study. Thirty-two of 83 children (39%) with anaphylaxis were treated with epinephrine. Respiratory symptoms during the OFC were treated significantly more often with epinephrine than gastrointestinal symptoms (P = .01). CONCLUSION Only 39% of children with anaphylaxis, according to the guideline criteria, were treated with epinephrine during the OFC and most of these children had respiratory symptoms. There is need for an easy-to-use international guideline for the treatment of allergic symptoms during OFCs.
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Affiliation(s)
- Johanna P M van der Valk
- Department of Internal Medicine, Allergology, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - Irene Berends
- Department of Internal Medicine, Allergology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Roy Gerth van Wijk
- Department of Internal Medicine, Allergology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Nicolette J T Arends
- Department of Pediatric Allergology, Erasmus Medical Center Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Maurits S van Maaren
- Department of Internal Medicine, Allergology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Hans de Groot
- Department of Pediatric Allergology, Diaconessenhuis Voorburg, RdGG, Delft, The Netherlands
| | - Harry J Wichers
- Wageningen UR Food and Biobased Research, Wageningen, The Netherlands
| | - Joyce A M Emons
- Department of Pediatric Allergology, Erasmus Medical Center Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Anthony E J Dubois
- Department of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
| | - Nicolette W de Jong
- Department of Internal Medicine, Allergology, Erasmus Medical Center, Rotterdam, The Netherlands
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