Abstract：
BACKGROUND: Few studies have assessed the nature of accidental allergic reactions (AAR). We assessed the prevalence and risk factors for AAR in Japanese children.
METHODS: This study included children with immediate-type hen\'s egg (HE), cow\'s milk (CM), wheat, or peanut allergy who developed allergic reactions within at least 2 years and were followed up regularly at a single national allergy center in Japan. From January to December 2020, low-dose reactivity was defined as allergic reactions to ≤250, ≤102, ≤53, or ≤ 133 mg of HE, CM, wheat, or peanut protein, respectively. The annualized AAR rate showed the number of reactions per patient per year (95% confidence interval). AAR risk factors were analyzed using multiple logistic regression.
RESULTS: Of the 1096 participants, 609, 457, 138, and 90 had HE, CM, wheat, and peanut allergies, respectively. The median (interquartile range) age was 5.0 (2.3-8.6) years, 39% had completely eliminated allergenic food, and 24% had low-dose reactivity. The annualized AAR rate was 0.130 (0.109-0.153) in all sub-cohorts. Moderate and severe symptoms occurred in 50% and 0.7%, respectively, of children who experienced AAR. Multiple logistic regression revealed that low-dose reactivity was a significant risk factor for AAR in the overall and CM cohorts, respectively (p < .001 and p = .036).
CONCLUSIONS: In this single-center study in Japan, the annualized AAR rate was relatively low during the COVID-19 pandemic; however, half of the participants with AAR had moderate to severe symptoms. Especially in the case of low-dose reactivity, children would require careful AAR risk management.
METHODS: This study included children with immediate-type hen\'s egg (HE), cow\'s milk (CM), wheat, or peanut allergy who developed allergic reactions within at least 2 years and were followed up regularly at a single national allergy center in Japan. From January to December 2020, low-dose reactivity was defined as allergic reactions to ≤250, ≤102, ≤53, or ≤ 133 mg of HE, CM, wheat, or peanut protein, respectively. The annualized AAR rate showed the number of reactions per patient per year (95% confidence interval). AAR risk factors were analyzed using multiple logistic regression.
RESULTS: Of the 1096 participants, 609, 457, 138, and 90 had HE, CM, wheat, and peanut allergies, respectively. The median (interquartile range) age was 5.0 (2.3-8.6) years, 39% had completely eliminated allergenic food, and 24% had low-dose reactivity. The annualized AAR rate was 0.130 (0.109-0.153) in all sub-cohorts. Moderate and severe symptoms occurred in 50% and 0.7%, respectively, of children who experienced AAR. Multiple logistic regression revealed that low-dose reactivity was a significant risk factor for AAR in the overall and CM cohorts, respectively (p < .001 and p = .036).
CONCLUSIONS: In this single-center study in Japan, the annualized AAR rate was relatively low during the COVID-19 pandemic; however, half of the participants with AAR had moderate to severe symptoms. Especially in the case of low-dose reactivity, children would require careful AAR risk management.
摘要：
背景：很少有研究评估意外过敏反应（AAR）的性质。我们评估了日本儿童AAR的患病率和危险因素。
方法：这项研究包括患有直接型鸡蛋（HE）的儿童，牛奶（CM），小麦,或花生过敏，在至少2年内出现过敏反应，并在日本的一个国家过敏中心定期随访。从2020年1月至12月，低剂量反应性定义为对≤250，≤102，≤53或≤133mgHE的过敏反应，CM,小麦,或者花生蛋白,分别。年度AAR率显示每位患者每年的反应次数（95％置信区间）。采用多因素logistic回归分析AAR危险因素。
结果：在1096名参与者中，609、457、138和90有他，CM,小麦,花生过敏,分别。中位数（四分位数范围）年龄为5.0（2.3-8.6）岁，39%的人完全消除了过敏食物，24%有低剂量反应性。所有子队列的年化AAR率为0.130(0.109-0.153)。中度和重度症状发生率分别为50%和0.7%，分别,经历过AAR的孩子。多元logistic回归显示，低剂量反应性是AAR在总体和CM队列中的重要危险因素，分别(p<.001和p=.036)。
结论：在日本的这项单中心研究中，在COVID-19大流行期间，年化AAR率相对较低；然而，一半的AAR患者有中度至重度症状.特别是在低剂量反应性的情况下，儿童需要谨慎的AAR风险管理。
方法：这项研究包括患有直接型鸡蛋（HE）的儿童，牛奶（CM），小麦,或花生过敏，在至少2年内出现过敏反应，并在日本的一个国家过敏中心定期随访。从2020年1月至12月，低剂量反应性定义为对≤250，≤102，≤53或≤133mgHE的过敏反应，CM,小麦,或者花生蛋白,分别。年度AAR率显示每位患者每年的反应次数（95％置信区间）。采用多因素logistic回归分析AAR危险因素。
结果：在1096名参与者中，609、457、138和90有他，CM,小麦,花生过敏,分别。中位数（四分位数范围）年龄为5.0（2.3-8.6）岁，39%的人完全消除了过敏食物，24%有低剂量反应性。所有子队列的年化AAR率为0.130(0.109-0.153)。中度和重度症状发生率分别为50%和0.7%，分别,经历过AAR的孩子。多元logistic回归显示，低剂量反应性是AAR在总体和CM队列中的重要危险因素，分别(p<.001和p=.036)。
结论：在日本的这项单中心研究中，在COVID-19大流行期间，年化AAR率相对较低；然而，一半的AAR患者有中度至重度症状.特别是在低剂量反应性的情况下，儿童需要谨慎的AAR风险管理。
