• Mikel Olabarri, Nuria Sanz, Sebastià Gonzalez-Peris, Paula Vazquez, Aranzazu Gonzalez-Posada, Nuria Diez, Ana Vinuesa, Javier Benito, and Santiago Mintegi.
• From the Pediatric Emergency Department, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces. University of the Basque Country, UPV/EHU. Bilbao, Basque Country, Spain.
• Pediatr Emerg Care. 2023 Oct 1; 39 (10): 755759755-759.

ObjectiveThis study aimed to identify the triggers of pediatric anaphylaxis in Spain and to analyze the circumstances of the episode.MethodsPlanned secondary analysis of a prospective observational multicenter study endorsed by the Spanish Society of Pediatric Emergencies including children aged younger than 18 years diagnosed with anaphylaxis in 7 Spanish pediatric emergency departments (EDs) between 2016 and 2018. We analyzed factors related to the anaphylaxis episode and its management.ResultsFour hundred fifty-three cases were registered, happening mainly at home (295 [65.1%]), school (65 [14.3%]), and street (61 [13.5%]). The median age was 5 years, 143 (31.6%) had previous episodes, and 165 (36.4%) had previously been prescribed an epinephrine autoinjector, used in 40 (24.2% of those prescribed). Two thirds were well-appearing when arriving to the pediatric ED. Food was the trigger in 396 (87.4%). In 349 with a single food involved, the most frequent were milk (108 [30.4%]), nuts (103 [29.0%]), hen's egg (40 [11.3%]), and fish (31 [8.7%]), with variations related to the age of the child.ConclusionsFood, especially milk and nuts, are responsible for most anaphylaxis diagnosed in Spanish pediatric EDs. Consideration should be given to improving health education due to the low use of epinephrine autoinjectors.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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