306 - Peanut Allergy and Anaphylaxis in Children and Adolescents in an Urban Multiethnic Community Hospital
Monday, May 1, 2023
9:30 AM – 11:30 AM ET
Poster Number: 306 Publication Number: 306.408
Sandy Ma, Flushing Hospital Medical Center, Flushing, NY, United States; Ronique Gordon, Flushing Hospital Medical Center, Queens, NY, United States; Leidi Pedraza Gonzalez, Flushing Hospital Medical Center, Flushing, NY, United States; Tayyaba Wajih, Flushing Hospital Medical Center, Jamaica, NY, United States; Lily Q. Lew, Flushing Hospital Medical Center, Flushing, NY, United States; Won Baik-Han, Flushing Hospital Medical Center, Flushing, NY, United States
Resident Flushing Hospital Medical Center Flushing, New York, United States
Background: The prevalence of food allergy (FA) and anaphylaxis (ANA) in the US has been increasing in recent decades. Peanut allergy (PA) is the most dangerous, causing 90% of deaths due to food-induced ANA. Risk factors for development of PA include a family history, history of egg allergy and atopic dermatitis, and soy consumption in infancy. Studies have shown that Hispanic and African American children are more likely to have FA and to have FA-ANA. There are no studies on risk factors for PA and ANA amongst children and adolescents in an urban multiethnic community hospital. Objective: To explore risk factors for PA and ANA in children and adolescents in an urban multiethnic community hospital. Design/Methods: This was a retrospective study of patients aged 1-18 years seen in Flushing Hospital Medical Center from January 2015 to December 2019 with diagnosis of PA. EHR was reviewed for demographics (age, gender, ethnicity), FA (nut, egg, shellfish, soy), allergy screen, presenting symptoms, age of diagnosis, hypoallergenic formula use, past medical history, ANA, body mass index (BMI), family history and medications. Patients were grouped into no ANA (nANA) and ANA for comparisons. Data were analyzed using SPSS, percentages and chi-square test, p< 0.05 was considered significant. Results: Of 128 patients with PA, 74 (56%) were male and the predominant ethnicities were Hispanic (60%), Asian (18%) and African American (15%). Diagnosis of PA was confirmed by ImmunoCap test in 108 (85%) at mean age of 5.1+4.1 years. Also positive were nuts (64%), egg (41%), soy (41%) and shellfish (38%). There were no significant differences between nANA (n=69, 54%) and ANA (n=59, 46%) groups for family history of asthma (16% vs 27%, p=0.16), family history of eczema (4% vs 7%, p=0.81), hypoallergenic formula in infancy (13% vs 7%, p=0.3) and personal history of asthma (48% vs 61%, p=0.19). However, family history of FA (0 vs 8%, p=0.02), higher average BMI (19.7+5.2 kg/m2 vs 21.9+5.2 kg/m2, p=0.04), increased use of oral steroids (20% vs 75%, p=0), dyspnea (4% vs 49%, p=0.0), nausea/emesis (9% vs 42%, p=0.0) and edema (7% vs 66%, p=0.0) were significant. Having rash (87% vs 93%, p=0.38) and eczema (55% vs 56%, p=1.0) were frequent in both groups. Almost all (93%) followed up with their specialist quarterly.
Conclusion(s): In our small sample of patients with PA, being Hispanic, male, having higher BMI, and being on steroids are risk factors for ANA, as is a family history of FA. There was almost full compliance with specialist follow-up visits.
