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Anaphylaxis in infants

Scott H Sicherer, MD, FAAAAI
Section Editor
Robert A Wood, MD
Deputy Editor
Elizabeth TePas, MD, MS


The prevalence of anaphylaxis in infancy, defined here as birth through two years of age, is unknown but appears to be increasing [1-4]. In a European anaphylaxis registry with 1970 patients younger than 18 years, 18 were under age one year (0.9 percent) [5]. In a review of children presenting with food-induced anaphylaxis to two Boston emergency departments, 29 percent were under age two years [6]. Anaphylaxis has been reported in infants as young as one week of age [7-9]. It can be fatal in infancy [10-12].

This topic reviews the unique features of anaphylaxis in infants. Other aspects of anaphylaxis are covered separately. (See "Anaphylaxis: Emergency treatment" and "Laboratory tests to support the clinical diagnosis of anaphylaxis" and "Food-induced anaphylaxis" and "Fatal anaphylaxis" and "Biphasic and protracted anaphylaxis".)


The diagnosis is based primarily upon a detailed history of the episode, including information about all exposures and events in the minutes to hours preceding the sudden onset of symptoms and signs. The clinical criteria for the diagnosis of anaphylaxis are similar in patients of all ages; however, some aspects of diagnosis are unique in infants (table 1) [6,13,14]. These clinical criteria have been validated for use in emergency departments and epidemiologic studies [15,16]. (See "Anaphylaxis: Acute diagnosis", section on 'Definition and diagnosis'.)

Anaphylaxis can be difficult to recognize in infancy for a variety of reasons [6,14]:

It is sometimes the first clinical manifestation of sensitization to an allergen. Caregivers might not realize what the symptoms and signs represent if they are unaware that the infant has been sensitized to this allergen.

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Literature review current through: Nov 2017. | This topic last updated: Nov 29, 2017.
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