Objective: To determine some factors associated to recurrent anaphylaxis induced by cow´s milk (CM) in pediatric patients with a previous anaphylactic episodes.
Methods: This is a retrospective study based on medical records from all CM anaphylactic patients, from a Brazilian reference center for food allergy. The anaphylaxis criterion used was based on the Second symposium on the definition and management of anaphylaxis. Patients and parents had received orientation regarding prevention of new episodes, including information about hidden allergens, label reading, and synonymous terms.
Results: It was included 53 patients (33M:20F), median age of the first episode of anaphylaxis was 6 months (range 1-87 mo) and in 56, 6% the first episode occurred until the age of six months. Fifty episodes were observed in 22 patients during the follow up. Twelve patients presented two or more episodes and two patients presented six episodes. It was not possible to detect the trigger food in 17 episodes and these situations were related to ingestion of: appetizers (4), margarine (3), bread (2), pizza (2), juice with casein (1), pasta (1), cake (1), chips (1), Italian sausage (1). Two episodes were challenged by accidentally skin contact and two by inhalation. Among the settings of episodes, the majority occurred at home. Other places included: school, restaurants and bakery.
Conclusions: This study showed that it is very difficult to reach success only with the orientations regarding anaphylaxis prevention. It is necessary to betake of other strategies to improve the measure to avoid new episodes of anaphylaxis such as: folders, visual midia and interactive activities. Furthermore, the continuous education is essential to reinforce the knowledge.