Clinical Characteristics and Management of Pediatric Egg-Induced Anaphylaxis: A Cross-Sectional Study

Background Egg is the third most common food allergy in children; however, data on pediatric egg-induced anaphylaxis are sparse. Objective We aimed to describe the clinical characteristics, management, and outcomes of pediatric egg-induced anaphylaxis. Methods Children presenting with anaphylaxis were recruited from 13 emergency departments as part of the Cross-Canada Anaphylaxis Registry (C-CARE), from which data on anaphylaxis triggered by egg were extracted. Multivariate logistic regression was used to determine factors associated with pre-hospital epinephrine autoinjector (EAI) use and to compare anaphylaxis triggered by egg to other triggers of food-induced anaphylaxis (FIA). Results We recruited 302 children with egg-induced anaphylaxis. The mean age was 2.6 years (Standard deviation=3.6) and 55.3% were male. Only 39.4% had previously been diagnosed with an egg allergy. Pre-hospital EAI use was 32.1%, but this was not significantly lower than in other triggers of FIA (P=0.26). Only 1.4% of patients required hospital admission. Relative to other triggers of FIA, patients with egg-induced anaphylaxis were significantly younger (P<0.001) and exhibited more vomiting (P=0.0053) and less throat tightness (P=0.0015) and angioedema (P<0.001). Conclusion To our knowledge, this is the largest published cohort of pediatric egg-induced anaphylaxis. In this cohort, pre-hospital EAI use was very low. Additionally, we identified certain symptoms that distinguish egg-induced from other triggers of FIA. Taken together, high suspicion is crucial in identifying egg-induced anaphylaxis, given the younger patient demographic and frequent lack of prior FIA history.