Drug-Induced Anaphylaxis in Children

Author:

Bianchi Annamaria1,Valluzzi Rocco2ORCID,Crisafulli Giuseppe3,Bottau Paolo4ORCID,Caimmi Silvia5,Franceschini Fabrizio6,Liotti Lucia6,Mori Francesca7,Riscassi Sara8,Saretta Francesca9ORCID,Scavone Sara10,Caffarelli Carlo10ORCID

Affiliation:

1. UOC Pediatria, Azienda Ospedaliera San Camillo Forlanini, 00152 Roma, Italy

2. Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children’s Hospital, IRCCS, 00152 Roma, Italy

3. UOC di Pediatria, Dipartimento Materno-Infantile, Università di Messina, 98100 Messina, Italy

4. UOC di Pediatria e Neonatologia, Ospedale di Imola (BO), 40026 Imola, Italy

5. SC di Pediatria Fondazione IRCSS Policlinico San Matteo, 27100 Pavia, Italy

6. UOC Pediatria, Azienda Ospedaliero-Universitaria “Ospedali Riuniti”, 60123 Ancona, Italy

7. Allergy Unit, Meyer Children’s Hospital IRCCS, 50132 Florence, Italy

8. UOC di Pediatria Ospedale di Bolzano, Azienda Sanitaria dell’Alto Adige, 39100 Bolzano, Italy

9. SC Pediatria, Ospedale Latisana-Palmanova, Dipartimento Materno-Infantile Azienda Sanitaria, Universitaria Friuli Centrale, 33100 Udine, Italy

10. Clinica Pediatrica, Dipartimento Medicina e Chirurgia, University of Parma, 43126 Parma, Italy

Abstract

Drug-induced anaphylaxis in children is less common than in adults and primarily involves beta-lactams and nonsteroidal anti-inflammatory drugs. Epidemiological studies show variable prevalence, influenced by age, gender, and atopic diseases. The pathophysiology includes IgE-mediated reactions and non-IgE mechanisms, like cytokine release reactions. We address drug-induced anaphylaxis in children, focusing on antibiotics, nonsteroidal anti-inflammatory drugs, neuromuscular blocking agents, and monoclonal antibodies. Diagnosis combines clinical criteria with in vitro, in vivo, and drug provocation tests. The immediate management of acute anaphylaxis primarily involves the use of adrenaline, coupled with long-term strategies, such as allergen avoidance and patient education. Desensitization protocols are crucial for children allergic to essential medications, particularly antibiotics and chemotherapy agents.

Publisher

MDPI AG

Reference94 articles.

1. EAACI guidelines: Anaphylaxis (2021 update);Muraro;Allergy,2022

2. Drug-induced anaphylaxis in children;Cardinale;Acta Biomed.,2019

3. Risk Factors for Severe Anaphylaxis in Children;Olabarri;J. Pediatr.,2020

4. Drug-Induced Anaphylaxis: An Update on Epidemiology and Risk Factors;Regateiro;Int. Arch. Allergy Immunol.,2020

5. Diagnosis and management of drug-induced anaphylaxis in children: An EAACI position paper;Gomes;Pediatr. Allergy Immunol.,2019

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