{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:13:35Z","timestamp":1790684015477,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Perioperative hypersensitivity (POH) reactions are rare but potentially life\u2010threatening and remain poorly characterised in children. We analysed the largest available French paediatric cohort to describe the epidemiology, causal agents, temporal trends and phenotypes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We pooled data from paediatric patients (<18\u2009years) included in six previously published GERAP surveys (1997\u20132012) and the GERAP computerised database (2017\u20132024), all evaluated in centres of the GERAP network according to current guidelines. The primary objective was to compare POH phenotypes with and without causal agent identification.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 4605 POH reactions recorded, 461 (10%) occurred in children (median age 14 [10\u201316] years; 47% female). Reactions were grade 1 in 50%, grade 2 in 23%, grade 3 in 26% and grade 4 in 1%. The causal agent was identified in 199 (43%) cases, mainly neuromuscular blocking agents (NMBAs) (31%), latex (30%) and antibiotics (16%). Identification was more frequent in anaphylaxis than in isolated cutaneous reactions (61% vs. 25%,\n p<\/jats:italic>\n \u2009<\u2009.001). Latex\u2010related reactions disappeared after 2017. Patients in whom a causal agent was identified had more severe reactions (grade 3\u20134: 46% vs. 13%;\n p<\/jats:italic>\n \u2009<\u2009.001), more cardiovascular and respiratory involvement, and higher acute serum tryptase (median 16.0 vs. 4.0\u2009\u03bcg\/L;\n p<\/jats:italic>\n \u2009<\u2009.001) than those without identification.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Paediatric POH are not uncommon and may be life\u2010threatening. All suspected reactions, including isolated cutaneous signs, warrant referral to specialised allergy centres given the still low identification rate and the continuing burden of NMBA\u2010 and antibiotic\u2010related reactions.<\/jats:p>\n \n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/pai.70474","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:46:21Z","timestamp":1789577181000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Paediatric perioperative hypersensitivity reactions: Analysis of the French\n GERAP<\/scp>\n network database"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6060-9438","authenticated-orcid":false,"given":"Mertes Paul","family":"Michel","sequence":"first","affiliation":[{"name":"UMR_S1255 EFS\u2010INSERM Unit Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4118-6385","authenticated-orcid":false,"given":"Pouessel","family":"Guillaume","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Children's Hospital Roubaix France"},{"name":"Paediatric Pulmonology and Allergy Department Jeanne de Flandre Hospital, Lille University Hospital (CHU) Lille France"},{"name":"Lille University, ULR 2694: METRICS Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2648-1693","authenticated-orcid":false,"given":"Gouel","family":"Aur\u00e9lie","sequence":"additional","affiliation":[{"name":"University Paris Cit\u00e9 Paris France"},{"name":"Anesthesiology and Critical Care Medicine Department DMU PARABOL, Bichat Hospital, AP\u2010HP Paris France"},{"name":"Antibody in Therapy and Pathology, Pasteur Institute, UMR 1222 INSERM Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karila","family":"Chantal","sequence":"additional","affiliation":[{"name":"Paediatric Pulmonology and Allergy Department Necker\u2010Enfants Malades Hospital, Paris\u2010Descartes University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7783-1281","authenticated-orcid":false,"given":"Lejus\u2010Bourdeau","family":"Corinne","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care CHU Nantes, H\u00f4tel Dieu \u2010 H\u00f4pital M\u00e8re Enfant Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franchina","family":"S\u00e9bastien","sequence":"additional","affiliation":[{"name":"Perioperative Allergic Reaction Exploration Unit, Department of Anesthesia and Intensive Care Rouen University Hospital Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7274-6018","authenticated-orcid":false,"given":"Tacquard","family":"Charles","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Strasbourg University Hospital Strasbourg France"},{"name":"UMR_S1255 EFS\u2010INSERM Unit, EFS Grand Est Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"For the GERAP Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2024.01.044"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30116-9"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2019.01.027"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.04.014"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14063"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2024.05.025"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X20964470"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13401"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.14354"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/87.4.549"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200309000-00007"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annfar.2004.10.013"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.03.003"},{"issue":"8","key":"e_1_2_11_15_1","first-page":"868","article-title":"Hypersensitivity reactions during anesthesia. 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