Observational studyPediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology2025
Anaphylaxis severity grade, during oral food challenges, assessed by five different classifications.
Observational study in Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Comparative evaluation of seven severity grading systems in pediatric oral food challenges: Distinctions between anaphylactic and non-anaphylactic reactions.The World Allergy Organization journal · 2026Article
- Novelties in the pragmatic management of anaphylaxis in pediatric age.European journal of pediatrics · 2026Review
- Innovative diagnostic techniques and their clinical implications in food allergy: current clinical practice and future perspectives.Frontiers in allergy · 2026Review
- Management of paediatric anaphylaxis: evaluation of clinical practice according to the 2024 Polish Paediatric Society guidelines.Postepy dermatologii i alergologii · 2026Article
- Anaphylaxis severity grade, during oral food challenges, assessed by five different classifications.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2025Observational
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Abstract
backgroundWhile the definition of anaphylaxis is clear, its grade of severity remains a subject of debate. The objective of this study was to evaluate the possible discrepancies in the severity scoring system for anaphylaxis in patients with a positive food challenge (OFC), differentiating anaphylactic and non-anaphylactic reactions, using the WHO for the 11th version of the International Classification of Diseases (ICD-11) as the main reference.
methodsWe conducted a retrospective observational study at the University Hospital of Montpellier, France, including patients with a positive food OFC between 2018 and 2022. We classified the severity of each reaction based on 5 different classifications. We also compared patients presenting an anaphylactic versus a non-anaphylactic reaction during the OFC in terms of symptoms and therapeutic approach.
results235 patients presented a positive OFC between January 2018 and December 2022: 143 (60.9%) suffered from anaphylaxis, according to the ICD-11 classification. When comparing the different classifications, a complete concordance was recorded in 8 patients (5.6%) only. All classifications showed a good sensitivity (99.3%-100%), but different specificity (67.4%-93.5%), and discrepancies between them were shown in most patients. Respiratory and gastrointestinal symptoms were significantly more frequent in the anaphylaxis group. Adrenaline was injected in only 47.6% of patients suffering from anaphylaxis, even in a specialized setting.
conclusionOur work highlights the need to refine the different scoring systems and, even better, to disseminate unified diagnostic criteria, such as the ICD-11 ones, to avoid the underdiagnosis of anaphylactic reactions and ensure appropriate management for all allergic patients.
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