Clinical features of acute anaphylaxis in patients admitted to a university hospital: an 11-year retrospective review (1985–1996)

Cianferoni, Antonella; Novembre, Elio; Mugnaini, Luca; Lombardi, Enrico; Bernardini, Roberto; Pucci, Neri; Vierucci, A

doi:10.1016/s1081-1206(10)62318-6

Cited by 112 publications

(79 citation statements)

References 33 publications

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“…They described an overall incidence rate for these reactions of 5.8%. Subsequent retrospective analyses continued to report relatively low incidence rates, such as 2% (from Cianferoni et al's review of 113 inpatients [14]), 3% (from Brady et al's ED review [15]), and 6% (from Lee and Greenes pediatric inpatient series [16]). The most recently published retrospective analyses further suggests relatively low incidence rates of 5.3% and 11% for biphasic responses [17,18].…”

Section: Epidemiology and Incidence Of Biphasic Anaphylaxismentioning

confidence: 99%

Biphasic Anaphylaxis: A Review of the Incidence, Characteristics and Predictors

Ellis¹

2010

TOALLJ

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While it has been recognized for over a quarter century that anaphylactic reactions have the potential to follow a biphasic course, reports on the incidence of biphasic anaphylaxis are conflicting, and the search for reliable predictive factors of such responses has been challenging. Further adding to the complexity of this clinical entity are the widely variable durations of the asymptomatic window, and the similarly variable reports on second phase severity. This review aims to provide the health care professional with a better understanding of the true incidence, nature, and risk factors for this type of reactivity by consolidating and summarizing the available literature on the topic of biphasic anaphylaxis. As our body of evidence builds, patterns are emerging to suggest that those patients with an initial presentation requiring more than one dose of epinephrine, those who have life-threatening initial presenting features, and those who otherwise take longer to stabilize, are in this higher risk group, and would be more likely to benefit from prolonged in hospital observation. Conversely, patients who respond rapidly to the immediate administration of epinephrine may be at lower risk, but this finding requires confirmation by others. Further prospective evaluations of biphasic anaphylaxis will greatly aid our understanding of this condition.

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Section: Epidemiology and Incidence Of Biphasic Anaphylaxismentioning

confidence: 99%

Biphasic Anaphylaxis: A Review of the Incidence, Characteristics and Predictors

Ellis¹

2010

TOALLJ

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“…48 An antihistamine (given intramuscularly) and a corticosteroid (given intravenously) should be added to this treatment. 13 Pretreatment with corticosteroids or with H1 antihistamines is still controversial. 14 These substances have been indicated for patients at high risk of having adverse reactions to iodine contrast media.…”

Section: Clinical Managementmentioning

confidence: 99%

“…12 Drug-induced anaphylactic reactions are believed to occur in approximately 0.95% of the general population. [13][14][15] Although anaphylactic reaction to penicillin is a rare event, this drug is still accountable for around 75% of fatal cases of anaphylaxis in the United States every year. 16 Thong et al, 2 in a prospective study conducted between 1997 and 1999, in a general hospital of Singapore, assessed approximately 90,910 admissions, of which 366 were due to adverse reactions, and of these 72 were AR (19%).…”

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confidence: 99%

Reações alérgicas a medicamentos

Nagão-Dias¹,

Barros-Nunes²,

Coêlho³

et al. 2004

J. Pediatr. (Rio J.)

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Objective: This review addresses the most recent published literature regarding drug allergy, in order to provide physicians with a background for a better understanding of this problem of great relevance for public health. Sources of data:The sources of data for obtaining the original and review articles published in the last 10 years were MEDLINE, Pubmed and Lilacs. The articles chosen for this review relate drug allergy to immunological mechanisms, epidemiology, clinical and laboratory evaluation, skin lesions, clinical management, and re-exposure to the drug.Summary of the findings: Allergic reactions represent one third of adverse drug reactions. They are considered rare but with high morbimortality. Gell & Coombs definition has been useful for classifying some types of drug allergic reactions; however, some still remain without classification because of poor knowledge of the mechanisms involved. The existence of T cell subpopulations with diverse characteristics reveals the complexity of the subject and, at the same time, elucidates several questions raised about it. It was recently postulated a new concept of chemically inert drug presentation to T cells, restricted to the major histocompatibility complex, but in a non-covalent and labile way. In clinical practice, without adequate laboratory tests, it is difficult to correlate clinical symptoms and immunological mechanisms. In vitro and in vivo skin tests have been employed in cases of suspected drug allergy reaction. However, there are very few commercially available reagents.Conclusions: Drug allergy constitutes an important problem in adverse drug reactions because of its potential of morbidity and mortality. It is necessary to emphasize the relevance of pharmacovigilance during treatment of patients, as well as the identification of possible immunological mechanisms involved in the events, through laboratory tests and detailed history and clinical evaluation.

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“…De éstos, 25 (48%) fueron por antibióticos y 18 (35%) por AINE. La prevalencia de anafilaxia inducida por AINE fue de 0,01% (4).…”

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Alergia e intolerancia a antiinflamatorios no esteroides: desensibilización exitosa en tres casos y revisión de la literatura

et al. 2009

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Los antiinflamatorios no esteroides son la segunda causa de reacciones a medicamentos después de los beta-lactámicos. La prevalencia de las reacciones a antiinflamatorios no esteroideos en la población general es de 0,1% a 0,3% y la prevalencia de anafilaxia inducida por ellos es de 0,01%. La intolerancia al ácido acetilsalicílico o a los antiinflamatorios no esteroides se presenta con síntomas como urticaria aguda, angioedema, crisis asmática, enfermedad respiratoria exacerbada por ácido acetilsalicílico y anafilaxia. Presentamos una revisión actualizada basada en tres casos de pacientes con intolerancia al ácido acetilsalicílico o a los antiinflamatorios no esteroideos que, por sus enfermedades concomitantes, requerían tratamiento permanente conácido acetilsalicílico. Después de someterlos a un protocolo de desensibilización rápida ácido acetilsalicílico en una unidad de cuidados intensivos, estos pacientes pudieron continuar recibiendo ácido acetilsalicílico diariamente sin efectos adversos.Palabras clave: hipersensibilidad a los medicamentos, aspirina, agentes antiinflamatorios no esteroides, desensibilización inmunológica, asma, anafilaxis, pólipos nasales, sinusitis. Allergy and intolerance to nonsteroidal antinflammatory drugs: successful desensitization in three casesAdverse reactions to nonsteroidal antinflammatory drugs are the second cause of reactions to drugs after beta-lactams. Prevalence of these reactions among general population is between 0.1-0.3%, and prevalence of nonsteroidal antinflammatory drug-induced anaphylaxis is 0.01%. Acetylsalicylic acid or nonsteroidal antinflammatory drug sensitivity can be manifested as acute urticaria, angioedema, acute asthma, acetylsalicylic acid exacerbated respiratory disease and anaphylaxis.An updated review based on three cases of patientes with acetylsalicylic acid or nonsteroidal antinflammatory drug intolerance is presented in which, because of their concomitant diseases, permanent treatment with acetylsalicylic acid was required. After undergoing a fast acetylsalicylic acid desentization protocol in an intensive care unit, these patients were able to receive daily acetylsalicylic acid doses without any adverse effects.Key words: Drug hypersensitivity; aspirin; anti-inflammatory agents, non-steroidal; desensitization, immunologic; asthma, anaphylaxis, nasal polyps, sinusitis. Los antiinflamatorios no esteroides (AINE) son reconocidos entre los agentes terapéuticos más frecuentemente usados en todo el mundo, con un consumo estimado de 80 tabletas por persona al año. Debido a esta magnitud de exposición, no es sorprendente que los AINE sean una de

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Clinical features of acute anaphylaxis in patients admitted to a university hospital: an 11-year retrospective review (1985–1996)

Cited by 112 publications

References 33 publications

Biphasic Anaphylaxis: A Review of the Incidence, Characteristics and Predictors

Biphasic Anaphylaxis: A Review of the Incidence, Characteristics and Predictors

Reações alérgicas a medicamentos

Alergia e intolerancia a antiinflamatorios no esteroides: desensibilización exitosa en tres casos y revisión de la literatura

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