New criteria from Boston-based Mass General for Children can accurately identify 98% of cases of anaphylactic children — compared to 85% with the older guidance.
The last modifications to allergic reaction guidance were published in 2006 by the National Institute of Allergy and Infectious Diseases and the Food Allergy and Anaphylaxis Network. In 2020, updates were recommended by the World Allergy Organization, but at the time were not evaluated in children under age 2. So that's what Mass General for Children set out to do.
Researchers from the hospital looked at 337 cases of pediatric patients with anaphylaxis diagnoses, which consisted of: 33% infants younger than 12 months, 39% toddlers between 12 and 36 months, and 29% children 36 months or older.
Not only did Mass General's expanded guidance detect 98% of allergic reactions overall — it also improved detection rates by 23% in infants as well as by more than 10% in toddlers, compared to existing standards the data, which was published May 20 in The Journal of Allergy and Clinical Immunology, showed.
"Some of our modifications are designed to accommodate the inability of infants to verbally express such symptoms as 'my tummy hurts,' 'my tongue is itchy,' or I'm dizzy,'" Anna Handorf, MD, a pediatrics specialist at Mass General for Children and co-author of the study stated in a news release. "For these cases, we've added surrogate signs such as infants pulling their legs up to their chest, and crying as a proxy for abdominal pain."