Usefulness of an artificial neural network to assess anaphylaxis severity

Anaphylaxis and digital medicine

PURPOSE OF REVIEW

Digital medicine (mHealth) aims to help patients and healthcare providers (HCPs) improve and facilitate the provision of patient care. It encompasses equipment/connected medical devices, mHealth services and mHealth apps (apps). An updated review on digital health in anaphylaxis is proposed.

RECENT FINDINGS

In anaphylaxis, mHealth is used in electronic health records and registries.It will greatly benefit from the new International Classification of Diseases-11 rules and artificial intelligence. Telehealth has been revolutionised by the coronavirus disease 2019 pandemic, and lessons learnt should be extended to shared decision making in anaphylaxis. Very few nonvalidated apps exist and there is an urgent need to develop and validate such tools.

SUMMARY

Although digital health appears to be of great importance in anaphylaxis, it is still insufficiently used.

Wheat Anaphylaxis in Adults Differs from Reactions to Other Types of Food

BACKGROUND

Wheat is one of the most commonly consumed foods and a known elicitor of anaphylaxis in children and adults. Reactions in adults are often cofactor dependent and characterized by a prolonged time between food intake and the onset of symptoms making the diagnosis of wheat anaphylaxis challenging.

OBJECTIVE

To characterize a cohort of patients with the history of wheat anaphylaxis to better understand this atypical phenotype of anaphylaxis.

METHODS

Data from the European Anaphylaxis Registry from 2007 to 2019 (n = 10,636) including 250 patients (213 adults and 37 children) with a history of anaphylaxis caused by wheat were analyzed.

RESULTS

Wheat was the most common food elicitor of anaphylaxis in adults in the registry in Central Europe. Reactions to wheat in adults were frequently associated with exercise as a cofactor (82.8%) and partially delayed (57.5%). Only 36.9% of patients had atopic comorbidities, which was uncommonly low for adult patients allergic to other kinds of foods (63.2%). Anaphylaxis to wheat presented frequently with cardiovascular symptoms (86.7%) including severe symptoms such as loss of consciousness (41%) and less often with respiratory symptoms (53.6%). The reactions to wheat were more severe than reactions to other foods (odds ratio [OR] = 4.33), venom (OR = 1.58), or drugs (OR = 2.11).

CONCLUSIONS

Wheat is a relevant elicitor of anaphylaxis in adults in Central Europe. Wheat anaphylaxis is highly dependent on the presence of cofactors and less frequently associated with atopic diseases compared with other food allergies. More data on mechanisms of wheat-induced anaphylaxis are required to develop preventive measures for this potentially life-threatening disease.