Pediatric anaphylaxis: unresolved issues of diagnosis and patient management

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The incidence of anaphylaxis is increasing in children. Children suffering from anaphylaxis represent a complex and ambiguous group of patients. The factors that cause difficulties in diagnosing anaphylaxis in children are as follows: a wide range of triggers, unpredictability of the nature, severity of clinical symptoms of systemic reactions, and their age-dependent interpretation. The first anaphylactic reaction always stuns parents and medical staff, which leads to a subjective description of the anamnesis and a delay in making a diagnosis and prescribing the correct treatment. For these patients, problems such as the lack of available diagnostic tests for verifying the diagnosis of anaphylaxis, restriction of standard doses of epinephrine autoinjectors, lack of predictors of the occurrence, and severity of systemic allergic reactions continue to be relevant.

The article focused on the most urgent difficulties and features of managing patients with anaphylaxis in pediatric practice and discussed possible prospects and ways to solve them.

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About the authors

Alexander N. Pampura

Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University

ORCID iD: 0000-0001-5039-8473
SPIN-code: 9722-7961

MD, Dr. Sci. (Med.)

Russian Federation, 2, Taldomskaya street, Moscow, 125412

Natalia V. Esakova

Veltischev Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University

Author for correspondence.
ORCID iD: 0000-0001-8792-2670
SPIN-code: 6924-9726

MD, Cand. Sci. (Med.)

Russian Federation, 2, Taldomskaya street, Moscow, 125412


  1. Lin RY, Anderson AS, Shah SN, Nurruzzaman F. Increasing anaphylaxis hospitalizations in the first 2 decades of life: New York State, 1990–2006. Ann Allergy Asthma Immunol. 2008;101(4):387–393. doi: 10.1016/S1081-1206(10)60315-8
  2. Poulos LM, Waters AM, Correll PK, et al. Trends in hospitalizations for anaphylaxis, angioedema, and urticaria in Australia, 1993–1994 to 2004–2005. J Allergy Clin Immunol. 2007;120(4):878–884. doi: 10.1016/j.jaci.2007.07.040
  3. Wang Y, Allen KJ, Suaini NH, et al. The global incidence and prevalence of anaphylaxis in children in the general population: a systematic review. Allergy. 2019;74(6):1063–1080. doi: 10.1111/all.13732
  4. Esakova N, Treneva M, Okuneva T, Pampura AN. Food anaphylaxis: reported cases in Russian federation children. Am J Public Health Research. 2015;3(5):187–191. doi: 10.12691/ajphr-3-5-2
  5. Lepeshkova TS. Analysis of the prevalence of food hypersensitivity and food anaphylaxis in the children’s population of Yekaterinburg. Russian Allergological Journal. 2021;18(2):46–54. (In Russ). doi: 10.36691/RJA1427
  6. Lee S, Hess EP, Lohse C, et al. Trends, characteristics, and incidence of anaphylaxis in 2001–2010: A population-based study. J Allergy Clin Immunol. 2017;139(1):182–188.e2. doi: 10.1016/j.jaci.2016.04.029
  7. Huang F, Chawla K, Jarvinen KM, Nowak-Węgrzyn A. Anaphylaxis in a New York City pediatric emergency department: triggers, treatments, and outcomes. J Allergy Clin Immunol. 2012;129(1):162–168. doi: 10.1016/j.jaci.2011.09.018
  8. Pampura AN, Esakova NV. Anaphylaxis in children. Moscow: ID MEDPRAKTIKA-M; 2020. 368 р. (In Russ).
  9. Cardona V, Ansotegui IJ, Ebisawa M, et al. World allergy organization anaphylaxis guidance, 2020. World Allergy Organ J. 2020;13(10):100472. doi: 10.1016/j.waojou.2020.100472
  10. Sampson HA, Munoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report ― Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2005;117(2):391–397. doi: 10.1016/j.jaci.2005.12.1303
  11. Astafyeva NG, Bayalieva AZ, Zabolotskikh IB, et al. Anaphylactic shock. Clinical recommendations. Russian Allergological Journal. 2021;18(1):56–72. (In Russ). doi: 10.36691/RJA1422
  12. Greenberger PA, Rotskoff BD, Lifschultz B. Fatal anaphylaxis: postmortem findings and associated comorbid diseases. Ann Allergy Asthma Immunol. 2007;98(3):252–257. doi: 10.1016/S1081-1206(10)60714-4
  13. Pumphrey R, Sturm G. Risk factors for fatal anaphylaxis. In: D.A. Moneret-Vautrin, ed. Advances in anaphylaxis management. London: Future Medicine; 2014. Р. 32–48. doi: 10.2217/fmeb2013.13.248
  14. Akin C, Soto D, Brittain E, et al. Tryptase haplotype in mastocytosis: relationship to disease variant and diagnostic utility of total tryptase levels. Clin Immunol. 2007;123(3):268–271. doi: 10.1016/j.clim.2007.02.007
  15. Heaps A, Carter S, Selwood C, et al. The utility of the ISAC allergen array in the investigation of idiopathic anaphylaxis. Clin Exp Immunol. 2014;177(2):483–490. doi: 10.1111/cei.12334.
  16. Sicherer SH, Simons FE; AAP Section on Allergy and Immunology. Epinephrine for first-aid management of anaphylaxis. Pediatrics. 2017;139(3):e20164006. doi: 10.1542/peds.2016-4006

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