Anaphylaxie de l'enfant

Anaphylaxis is a severe and potentially life-threatening allergic emergency that has increased in frequency and over the two last decades, especially in young children. Death through anaphylactic shock remains rare, in particular in children, and its frequency has remained stable throughout this period. Food is the chief cause of anaphylactic shock in children, with cow's milk, peanuts and tree nuts being the mostly frequently incriminated foodstuffs. In infants, anaphylactic shock may be difficult to recognise. Vomiting, urticaria and laryngeal oedema are more frequent at this age. Cardiovascular involvement is rare and is most often encountered in adolescents. A history of asthma or atopy, allergy to particular foods such as peanuts and tree nuts, and adolescence, all constitute risk factors for anaphylaxis and more severe reactions. First-line treatment consists of intramuscular adrenaline for all patients in anaphylactic shock. There are no absolute contraindications. Guidelines for the prescription of adrenaline auto-injectors and for the conditions of establishment of personalized care projects for allergic children in schools have recently been updated. Improvements continue to be needed in the recognition and treatment of anaphylactic shock.