L’anaphylaxie alimentaire chez le sénior : analyse des données du RAV de 2002 à 2020
(2022) Revue Française d’Allergologie — Vol. 62, n° 2, p. 121-132 (2022)
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- Authors
Perennec, Tanguy 
Pirson, Françoise
- Abstract
- (en) [Food anaphylaxis in someone elderly: Review of the RAV data, 2002 to 2020] Between 2002 and 2020, 172 food anaphylaxis cases in senior citizens were reported to the RAV. Sex ratio M/F was 0.85 and the average age was 67.3 years (60–93). The most frequent allergens are of plant origin: first, legumes (20 cases), then cereals (16 cases) and nuts (15 cases), mainly hazelnut. PR-10 proteins are involved in at least 11.7% of anaphylaxis cases. Like soy, anaphylaxis attributed to Cor a 1 is mainly reported by allergists practicing in Belgium and northeastern France. Anaphylaxis related to red meat and offal is the most frequent (24 cases, 13.9%), always associated with an alphaGal syndrome when anti-alphaGal IgE was tested. Sixteen are attributed to crustaceans, 8 to mollusks and fish respectively and 6 to Anisakis. This series confirms the rarity of cow's milk and egg allergy in the elderly. The RAV collected 4 grade I, 77 grade II, 84 grade III and 5 grade IV anaphylaxis cases including one death. Severity was significantly related to a history of heart disease or hypertension. Forty percent of the subjects had already presented an allergy in the past with the suspected food and only 55% had an adrenaline pen and 33% an action plan. This large series underlines the interest of a detailed allergological assessment in the elderly. Their management should not only include an emergency care protocol with an adrenaline auto-injector, but also therapeutic and dietary education for patient, his family and entourage. It should be formalized by a personalized care project (PCP), as for schoolchildren, given the risk of recurrence, comorbidities and loss of autonomy for some.
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Citations
El Hanache, H., Perennec, T., Beaumont, P., Puillandre, E., Schwender, D., Louis Donguy, F., Van Der Brempt, X., Froidefond, C., Jarlot, S., Petit, N., Nootens, C., Pirson, F., Sullerot, I., & Morisset, M. (2022). L’anaphylaxie alimentaire chez le sénior : analyse des données du RAV de 2002 à 2020. Revue Française d’Allergologie, 62(2), 121-132. https://doi.org/10.1016/j.reval.2021.12.005 (Original work published 2022)