Age-related anaphylaxis patterns identified in 116-child single-center study

A retrospective study of 116 children treated at one pediatric allergy clinic found that the triggers and clinical manifestations of anaphylaxis varied with age. Food-induced reactions were significantly more frequent among children aged 0–5 years, whereas drug-induced reactions were more common in older children. Cardiovascular involvement was more frequent in patients aged 12 years or older and in reactions triggered by Hymenoptera venom or drugs, while neurological involvement was more frequent in the youngest age group.

Researchers analyzed children aged 0–18 years who were treated at the clinic between April 1, 2023, and July 1, 2025. Potential cases were identified using anaphylaxis-related ICD-10 codes and then reassessed against the diagnostic criteria of the World Allergy Organization 2020 and the European Academy of Allergy and Clinical Immunology 2021. The analysis covered demographics, triggers, clinical manifestations, treatment, laboratory findings, and clinical outcomes. Because this was a retrospective, observational study at a single specialist center, its findings describe the included cohort and may not represent all children treated elsewhere.

The 116 patients included 45 girls, or 38.8% of the cohort, and had a mean age of 9.7 ± 5.9 years. Anaphylaxis occurred most often at home, accounting for 66.4% of cases, and oral exposure was the most frequent route of allergen exposure at 67.2%. Foods were the most common trigger category, responsible for 42.2% of reactions, followed by drugs at 37.1% and Hymenoptera venom at 12.9%. Among food allergens, tree nuts, cow’s milk, and hen’s egg were the leading triggers identified in the study.

The age pattern differed by trigger category and clinical feature. Food-induced anaphylaxis was significantly more frequent in children aged 0–5 years, while drug-induced reactions were more common in older patients. Cardiovascular involvement occurred more frequently among those aged at least 12 years and in Hymenoptera venom- and drug-induced reactions. Neurological involvement was more frequent in children aged 0–5 years. Hymenoptera venom-induced reactions had the shortest onset time among the reported trigger groups, with a median of 15 minutes and an interquartile range of 5–30 minutes.

Intramuscular epinephrine was administered to 94.0% of the patients. Moderate-to-severe anaphylaxis was observed in 64 patients. In a multivariable logistic regression analysis, a history of food allergy was independently associated with moderate-to-severe anaphylaxis, with an odds ratio of 5.08, a 95% confidence interval of 1.32–19.52, and a p-value of 0.018. This was an association measured in the retrospective cohort, not evidence that food allergy caused severe reactions. The estimate also carried substantial uncertainty, as reflected by its wide confidence interval. Overall, the investigators reported that pediatric anaphylaxis manifestations and triggers varied according to age and concluded that a history of food allergy may indicate increased risk for moderate-to-severe anaphylaxis.

Subject of Research: Age-related variation in pediatric anaphylaxis triggers, manifestations, and severity in a 116-child retrospective cohort

Article Title: Age-related differences in pediatric anaphylaxis: a single-center experience

Article References: Çelik, E., & Yüksel Bulut, H. (2026). Age-related differences in pediatric anaphylaxis: a single-center experience. BMC Pediatrics, 26(1), Article 872. https://doi.org/10.1186/s12887-026-07619-3

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07619-3

Keywords: pediatric anaphylaxis, food allergy, drug reactions, Hymenoptera venom, epinephrine, age differences, clinical severity, retrospective cohort, food-induced reactions, Age-related, differences, pediatric