Salo M, et al. - Authors gauged if children with IgE-mediated allergy have a lower risk of complicated appendicitis. As per results, a lower risk of complicated appendicitis was seen in the children with IgE-mediated allergy. The clinical pattern of appendiceal disease seems modified by immunologic disposition. For one of childhood’s most common surgical emergencies, novel opportunities for understanding its pathogenesis and clinical decision making were introduced in these findings.

Methods

• In this retrospective cohort study, experts included all consecutive patients younger than 15 years who had an appendectomy for acute appendicitis at a tertiary pediatric surgery center in Sweden from January 1, 2007 through July 31, 2017.
• They stratified the children between those with and without IgE-mediated allergies.
• Main outcome and measures included the risk of complicated appendicitis with gangrene or perforation, with occurrence of IgE-mediated allergy as an independent variable, and adjusted for age, sex, primary health care contacts, seasonal antigenic exposure, allergy medications, appendicolith, and duration of symptoms.

Results

• As per data, out of 605 included children (63.0% boys; median age, 10 years; interquartile range, 7-12 years), 102 (16.9%) had IgE-mediated allergy and 503 (83.1%) had no allergy.
• In 20 children with IgE-mediated allergy (19.6%), complicated appendicitis occurred vs 236 with no allergy (46.9%; adjusted odds ratio, 0.33; 95% CI, 0.18-0.59).
• Findings did not suggest any significant allergy impact modification by sex, seasonal antigenic exposure, or allergy medication.
• A shorter hospital stay was seen in the children with IgE-mediated allergy (median, 2 days for both groups; interquartile range, 1-2 days vs 1-5 days; P=.004).