Sesame-induced anaphylaxis in pediatric patients from the cross-Canada anaphylaxis registry Journal Articles uri icon

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  • BACKGROUND: Sesame can cause severe allergic reactions and is a priority allergen in Canada. OBJECTIVE: To assess clinical characteristics and management of pediatric sesame-induced anaphylaxis and identify factors associated with epinephrine treatment. METHODS: Between 2011 and 2021, children with sesame-induced anaphylaxis presenting to 7 emergency departments (ED) in 4 Canadian provinces and 1 regional emergency medical service were enrolled in the Cross-Canada Anaphylaxis Registry. Standardized recruitment forms provided data on symptoms, severity, triggers, and management. Multivariate logistic regression evaluated associations with epinephrine treatment pre-ED and multiple epinephrine dosages. RESULTS: Of all food-induced anaphylactic reactions (n = 3279 children), sesame accounted for 4.0% (n = 130 children), of which 61.5% were boys, and the average (SD) age was 5.0 (4.9) years. Hummus containing sesame paste triggered 58.8% of reactions. In the pre-ED setting, 32.3% received epinephrine, and it was more likely to be used in boys (adjusted odds ratio [aOR], 1.27; 95% confidence interval [CI], 1.08-1.50) and those with a known food allergy (aOR, 1.36; 95% CI, 1.11-1.68]). In the ED, 47.7% of cases received epinephrine, with older children more likely to receive multiple epinephrine doses (aOR, 1.00; 95% CI, 1.00-1.02). CONCLUSION: In Canada, hummus is the major trigger of sesame-induced anaphylaxis. Knowledge translation focused on prompt epinephrine use and product-labeling policies are required to limit sesame reactions in communities.


  • Sillcox, Carly
  • Gabrielli, Sofianne
  • Clarke, Ann E
  • Morris, Judy
  • Gravel, Jocelyn
  • Lim, Rodrick
  • Chan, Edmond S
  • Goldman, Ran D
  • O'Keefe, Andrew
  • Gerdts, Jennifer
  • Chu, Derek
  • Upton, Julia
  • Hochstadter, Elana
  • Moisan, Jocelyn
  • Bretholz, Adam
  • McCusker, Christine
  • Zhang, Xun
  • Protudjer, Jennifer LP
  • Abrams, Elissa M
  • Simons, Elinor
  • Ben-Shoshan, Moshe

publication date

  • September 2022