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Objective To identify risk factors associated with severe anaphylaxis in children STUDY DESIGN We carried out a multicenter prospective observational study including children less than 18 years old diagnosed with anaphylaxis in 7 Spanish pediatric emergency departments (ED) between May 2016 and April 2018. Children were considered to have severe anaphylaxis if they met one or more of the following criteria requirement for two or more doses of epinephrine, clinically important biphasic reaction, endotracheal intubation, intensive care un