By David Douglas

NEW YORK (Reuters Health) - A review of allergic reactions in children shows that most reactions occur at home, most are triggered by peanuts or cashews, and treatment is often delayed.

"Health care professionals should ensure that children and their parents are able to recognize the signs and symptoms of allergic reactions," Dr. Mimi L. K. Tang from Royal Children's Hospital, Melbourne, Australia, told Reuters Health.

"All patients should have a written allergic reaction or anaphylaxis action plan to help facilitate this," she added.

Anaphylaxis is a severe allergic reaction that develops quickly, within seconds or minutes of exposure, causing a life-threatening response of the immune system involving the whole body. The immune system releases histamine and other substances that cause tightening of the airways and shock. Common causes of anaphylaxis are foods, drugs or insect bites.

In the August issue of the journal Allergy, Tang and colleagues report on their review of case notes on 123 anaphylactic reactions in 117 children over a 5-year period. The median age of the children was 2.4 years. Only 17 percent of the children had previously experienced an allergic reaction.

There was 1 death, in a 7-year old girl with a known peanut allergy who ate a peanut satay sauce. Most events (48 percent) took place at home, and almost all initially involved breathing and skin symptoms. Gastrointestinal and cardiovascular effects were also common.

The median time from exposure to the offending agent to allergic reaction was 10 minutes, and the median time until treatment was 40 minutes.

Food was the most common trigger (85 percent), with peanuts (18 percent) and cashew nuts (13 percent) the most common cause. Six percent of allergic reactions were caused by drugs and 3 percent by insect stings.

The researchers say their findings are similar to those of a study conducted in the 1990s in England, "suggesting that triggers for anaphylaxis in children have not changed significantly over the last decade."

SOURCE: Allergy, August 2008.

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