PMID- 28380495
OWN - NLM
STAT- MEDLINE
DCOM- 20170829
LR  - 20220409
IS  - 1423-0097 (Electronic)
IS  - 1018-2438 (Print)
IS  - 1018-2438 (Linking)
VI  - 172
IP  - 3
DP  - 2017
TI  - Risk Factors for Severe Reactions during Double-Blind Placebo-Controlled Food 
      Challenges.
PG  - 173-182
LID - 10.1159/000458724 [doi]
AB  - BACKGROUND: 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. METHODS: 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. RESULTS: 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, p = 0.003), 
      older age (per 1 year increase, adjusted OR: 1.102, p = 0.044), and an egg OFC 
      (adjusted OR: 0.433, p = 0.003). CONCLUSIONS: 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.
CI  - (c) 2017 The Author(s) Published by S. Karger AG, Basel.
FAU - Yanagida, Noriyuki
AU  - Yanagida N
AD  - Department of Pediatrics, Sagamihara National Hospital, Sagamihara, Japan.
FAU - Sato, Sakura
AU  - Sato S
FAU - Asaumi, Tomoyuki
AU  - Asaumi T
FAU - Ogura, Kiyotake
AU  - Ogura K
FAU - Ebisawa, Motohiro
AU  - Ebisawa M
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
DEP - 20170406
PL  - Switzerland
TA  - Int Arch Allergy Immunol
JT  - International archives of allergy and immunology
JID - 9211652
RN  - 0 (Allergens)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - YKH834O4BH (Epinephrine)
SB  - IM
MH  - Administration, Oral
MH  - Allergens/administration & dosage/*adverse effects/immunology
MH  - Anaphylaxis/drug therapy/etiology
MH  - Animals
MH  - Arachis/adverse effects/immunology
MH  - Child
MH  - Desensitization, Immunologic/*adverse effects
MH  - Double-Blind Method
MH  - Eggs/adverse effects
MH  - Epinephrine/therapeutic use
MH  - Female
MH  - Food Hypersensitivity/immunology/*therapy
MH  - Humans
MH  - Immunoglobulin E/blood/immunology
MH  - Male
MH  - Milk/adverse effects/immunology
MH  - Odds Ratio
MH  - Triticum/adverse effects/immunology
PMC - PMC5475236
OTO - NOTNLM
OT  - Anaphylaxis
OT  - Children
OT  - Food hypersensitivity
OT  - Oral food challenge
OT  - Pediatric patients
EDAT- 2017/04/06 06:00
MHDA- 2017/08/30 06:00
PMCR- 2017/04/06
CRDT- 2017/04/06 06:00
PHST- 2016/02/22 00:00 [received]
PHST- 2017/01/31 00:00 [accepted]
PHST- 2017/04/06 06:00 [pubmed]
PHST- 2017/08/30 06:00 [medline]
PHST- 2017/04/06 06:00 [entrez]
PHST- 2017/04/06 00:00 [pmc-release]
AID - 000458724 [pii]
AID - iaa-0172-0173 [pii]
AID - 10.1159/000458724 [doi]
PST - ppublish
SO  - Int Arch Allergy Immunol. 2017;172(3):173-182. doi: 10.1159/000458724. Epub 2017 
      Apr 6.