Clinical characteristics of anaphylaxis and risk factors for severe reactions in children: a single-center experience

Background This study aimed to analyze the clinical characteristics, severity, and risk factors for severe outcomes of anaphylactic reactions in pediatric patients. Methods This study examined 107 pediatric anaphylaxis cases from September 2020 to July 2025. A retrospective analysis was performed on demographic data, clinical features, laboratory results, and allergen triggers. Patients were categorized by reaction severity for comparative analysis. Multivariate logistic regression was used to identify risk factors for severe anaphylaxis. Results Among the 107 children included in this study, male 64 cases (59.81%) and female 43 cases(40.18%), ages ranged from 1 month to 15 years. Food was the most common trigger (62.61%, 67/107). In children under 1 year, egg allergy was most prevalent (37.50%, 6/16), while in those over 6 years, fruit allergy predominated (37.50%, 15/40). Antibiotic allergy was the most common drug-related trigger across all age groups (44.44%, 13/26). Severe anaphylaxis was more prevalent in children over 6 years old (36/47 vs. 34/60, p = 0.031), males (34/47 vs. 30/60, p = 0.019), and those with drug allergies (16/47 vs. 10/60, p = 0.037). Multivariate logistic regression identified male sex, age over 6, drug allergies, and short onset time as significant risk factors for severe anaphylaxis. Conclusions Food is the primary trigger for anaphylaxis in children, with allergen types and severity varying by age. Male children, those over 6 years old, children with drug allergies, and those with rapid-onset reactions are at higher risk for severe anaphylaxis and require focused clinical attention.