Anaphylaxis epidemic: Fact or fiction?

Simons, F. Estelle R.; Sampson, Hugh A.

doi:10.1016/j.jaci.2008.10.019

Cited by 88 publications

(58 citation statements)

References 30 publications

(45 reference statements)

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“…Themes that were common to physicians, patients, and caregivers in all settings were insufficient knowledge of anaphylaxis and its management, and how to use epinephrine auto-injectors. Consideration of these gaps is particularly important given the increasing prevalence of anaphylaxis, especially in young children (74). Although this apparent rise in the prevalence of anaphylaxis may be explained by the recently broadened definition of anaphylaxis (2,75), the findings of our review highlight the current landscape of anaphylaxis management across different settings and populations.…”

Section: Discussionmentioning

confidence: 90%

Gaps in anaphylaxis management at the level of physicians, patients, and the community: a systematic review of the literature

Kastner

Harada

Waserman

2010

Allergy

116

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To cite this article: Kastner M, Harada L, Waserman S. Gaps in anaphylaxis management at the level of physicians, patients, and the community: a systematic review of the literature. Allergy 2010; 65: 435–444.AbstractDiagnosis and management of anaphylaxis can be a challenge because reactions are often unexpected and progress quickly. The focus of anaphylaxis management has mostly been on the acute episode, with little attention given to the long‐term management of patients at risk. This is compounded by conflicting information in current guidelines and a general lack of agreement among clinicians about which management strategies are the most appropriate. We systematically reviewed the literature to identify and summarize studies that investigated gaps in anaphylaxis management. Our search included MEDLINE, EMBASE, CINAHL, and Evidence‐Based Medicine Reviews. Studies were included if they addressed an outcome describing gaps in anaphylaxis knowledge, education, anaphylaxis management, and quality of life (QOL). Populations of interest were health care professionals involved in the care of patients at risk for anaphylaxis, and patients of any age, their parents, caregivers, and teachers in primary care, hospital or community settings. Of 5014 citations that were identified, the final 59 studies (selected from 75 full‐text articles) met the inclusion criteria. Two hundred and two gaps were identified and classified according to major themes: gaps in knowledge and anaphylaxis management (physicians and patients); gaps in follow‐up care (physicians); and QOL of patients and caregivers. Findings from this systematic review revealed gaps in anaphylaxis management at the level of physicians, patients, and the community. Findings will be used to provide a basis for developing interventional strategies to help address these deficiencies.

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Section: Discussionmentioning

confidence: 90%

Gaps in anaphylaxis management at the level of physicians, patients, and the community: a systematic review of the literature

Kastner

Harada

Waserman

2010

Allergy

116

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“…respiratory distress) after ingestion of peanut or peanut-containing food, or after inhalation or skin exposure to peanut. Recent studies have shown that asthma-like respiratory distress is often involved in mortality due to food allergy [35]. Two cases of anaphylaxis with unconsciousness were also reported in the group positive for Ara h 1–3.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of IgE Antibodies to Recombinant Peanut Allergens in Patients with Reported Reactions to Peanut

Movérare¹,

Ahlstedt

Bengtsson

et al. 2011

Int Arch Allergy Immunol

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Background: Peanut may cause severe reactions in allergic individuals. The objective was to evaluate IgE antibodies to various recombinant (r) peanut and birch pollen allergens in relation to IgE levels to whole peanut extract and severe allergic reactions to peanut. Methods: Seventy-four Swedish peanut-allergic patients (age: 14–61 years) reported previous peanut exposure and associated symptoms using a questionnaire. Their IgE reactivity to peanut, birch pollen and individual allergen components was analyzed using ImmunoCAP®. Results: Of the 48 subjects sensitized to Ara h 1, 2 or 3, 60% had peanut-specific IgE levels >15 kU_A/l, while 100% of the subjects without detectable IgE to these allergens had low peanut-specific IgE levels (<10 kU_A/l). The levels of IgE to rAra h 8, rBet v 1 and birch pollen were highly correlated (r_S = 0.94, p < 0.0001). Fifty-eight patients reported adverse reactions after accidental or deliberate peanut exposure (oral, inhalation or skin) of whom 41 had IgE to rAra h 1, 2 or 3. Symptoms of respiratory distress were associated with sensitization to Ara h 1, 2 or 3 (56 vs. 18%, p < 0.01). Two cases of anaphylaxis were reported among the individuals sensitized to Ara h 1–3. IgE to rAra h 8, rAra h 9, profilin or cross-reactive carbohydrate determinants were not associated with severe symptoms. Conclusions: The results indicate that IgE reactivity to Ara h 1, 2 and 3 is associated with severe reactions after exposure to peanut in Swedish patients.

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“…Anaphylaxis is a potentially life-threatening event [1] whose incidence is believed to be rising [2,3]. Published series are usually based on data from emergency departments, outpatient allergy clinics and health maintenance organizations [4,5,6,7,8,9].…”

Section: Introductionmentioning

confidence: 99%

Incidence of Anaphylaxis in Hospitalized Patients

Tejedor-Alonso

Moro²,

Hernández³

et al. 2011

Int Arch Allergy Immunol

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Background: Only two studies have analyzed the incidence of anaphylaxis during admission to hospital. We have analyzed the incidence of anaphylaxis among hospitalized patients and determined the timing of and risk factors for episodes of anaphylaxis. Methods: Our study was performed between 1999 and 2005. We used the definition of anaphylaxis of the NIAID-FAAN symposium. Cases of anaphylaxis were extracted from an official database of discharge diagnoses coded according to the International Classification of Diseases, Clinical Modification, Ninth Revision (ICD-9-CM), Sixth Edition. Specific and generic codes related to anaphylaxis were chosen. This strategy revealed 83.3% (95% confidence interval, CI, 47–99%) of all episodes of anaphylaxis in a pilot study. The incidence of episodes of anaphylaxis and the hazard ratios were calculated for the different variables. Results: We observed a crude cumulative incidence of 1.5 episodes of anaphylaxis (95% CI, 0.9–1.9) in 5,000 admissions. The cumulative incidence according to the Standardized European Population was 1.6 cases in 5,000 admissions (95% CI, 0.8–2.3). Cox regression analysis showed that anaphylaxis occurs mainly in young people (0.97; 95% CI, 0.95–0.99) and its incidence differs according to the clinical unit. The Vascular Surgery Unit had the highest incidence rate (hazard ratio 7.7; 95% CI, 2.1–28.6). Males had a lower risk of suffering from anaphylaxis than females (0.5; 95% CI, 0.2–0.9). Conclusions: Anaphylaxis is a very rare event among hospitalized patients. Female gender, young age and admission to the Vascular Surgery Unit favored the occurrence of episodes of anaphylaxis among hospitalized patients.

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Anaphylaxis epidemic: Fact or fiction?

Cited by 88 publications

References 30 publications

Gaps in anaphylaxis management at the level of physicians, patients, and the community: a systematic review of the literature

Gaps in anaphylaxis management at the level of physicians, patients, and the community: a systematic review of the literature

Evaluation of IgE Antibodies to Recombinant Peanut Allergens in Patients with Reported Reactions to Peanut

Incidence of Anaphylaxis in Hospitalized Patients

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