Drug-related fatal anaphylactic shock in Denmark 1968–1990. A study based on notifications to the Committee on Adverse Drug Reactions

Lenler-Petersen, P; Hansen, Dennis Lund; Andersen, Martin Marchman; Sørensen, Henrik Toft; Bille, H

doi:10.1016/0895-4356(94)00235-i

Cited by 42 publications

(34 citation statements)

References 9 publications

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“…Recent figures from the USA have suggested an equal male : female ratio for fatal nut allergy [18]. Fatal contrast media reactions and sting reactions were more common in males, concordant with previous studies [19,20].…”

Section: Sexsupporting

confidence: 78%

Anaphylaxis: can we tell who is at risk of a fatal reaction?

Pumphrey¹

2004

Current Opinion in Allergy &Amp; Clinical Immunology

296

230

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Most fatal anaphylactic reactions are unpredictable. The appropriate management after recovery from a severe reaction may be protective against a fatal recurrence. An accurate identification of the cause and effective avoidance is a crucial part of this management, together with effective treatment of asthma for those with food allergy, immunotherapy for sting allergy, the avoidance of drugs that potentiate anaphylaxis, and effective training in self-treatment.

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Section: Sexsupporting

confidence: 78%

Anaphylaxis: can we tell who is at risk of a fatal reaction?

Pumphrey¹

2004

Current Opinion in Allergy &Amp; Clinical Immunology

296

230

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“…3 The estimated incidence of fatal anaphylaxis in a number of reports is 3 to 4 cases in every 10,000,000 inhabitants. 4 Recognized primary causes of anaphylaxis resulting deaths range from drugs, insect venoms, food, and even exercises. Approximately half of the fatal reactions recorded each year in the United Kingdom were iatrogenic and at least onefourth were due to food or insect venom.…”

Section: Discussionmentioning

confidence: 99%

Systemic Anaphylaxis Following Local Lidocaine Administration During a Dental Procedure

Chiu

Lin

Hsia

et al. 2004

Pediatric Emergency Care

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We report a 4-year-old child who developed systemic anaphylactic reaction to lidocaine hydrochloride within 15 minutes after a dental procedure. Hypersensitivity to local anesthetics is not common; however, if anaphylaxis did happen, it required emergent and immediate resuscitation. To prevent such complications, complete medical history including drug allergy should be taken. Prompt administration of epinephrine and other resuscitative measures are life saving in such circumstance. All emergency room physicians should consider systemic anaphylaxis in patients with rapid vascular collapse and respiratory failure immediately following lidocaine administration for minor outpatient procedures.

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“…Regarding penicillin, a retrospective study from 2004 that involved 3,375,162 patients who received a prescription for penicillin reported an allergy-like reaction in 6,212 (0.18%) 2. The Danish Drug Administration has identified 30 cases of fatal anaphylactic shock due to drugs in the Danish population of 5 million people from 1968 to 1990 3. Of these 30 fatal reactions, seven were caused by antibiotics: penicillin in four cases, ampicillin in two, and a sulfa drug in one.…”

Section: Introductionmentioning

confidence: 99%

Challenge Test Results in Patients With Suspected Penicillin Allergy, but No Specific IgE

Holm

Mosbech

2011

Allergy Asthma Immunol Res

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PurposePatients with a history of allergic reaction to penicillin, but with no detectable specific IgE, are common and pose a dilemma. Challenge tests are considered to be the diagnostic gold standard. The aim of this study was to identify subgroups of patients with very low risk for reactions who could be safely tested using a more rapid and simple procedure.MethodsA total of 580 consecutively referred adult patients with a history of non-serious cutaneous allergic reactions to penicillin, but with no IgE, were challenged with therapeutic doses of penicillin V (phenoxymethylpenicillin), penicillin G (benzylpenicillin), or both.ResultsOnly 14 of 580 patients had a positive challenge test. In 11 of the 14, a reaction to challenge occurred within 2 hours, and none were anaphylactic. The year of the original reaction was known for 555 patients; a positive challenge was seen in only 0.4% of those with an original reaction >15 years before challenge, but in 4.6% of those with a more recent original reaction (P=0.001). Onset of a reaction within the first day of the original exposure was a predictive factor for a positive challenge (P=0.001) in patients challenged within 15 years of the original reaction.ConclusionsAmong suspected penicillin-allergic patients with non-severe skin reactions and no detectable specific IgE, the subgroup of patients who originally reacted more than 15 years previously had very low risk for reacting to a challenge. The risk was higher in patients with a more recent original reaction, especially if the symptoms had occurred within the first day of exposure.

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Drug-related fatal anaphylactic shock in Denmark 1968–1990. A study based on notifications to the Committee on Adverse Drug Reactions

Cited by 42 publications

References 9 publications

Anaphylaxis: can we tell who is at risk of a fatal reaction?

Anaphylaxis: can we tell who is at risk of a fatal reaction?

Systemic Anaphylaxis Following Local Lidocaine Administration During a Dental Procedure

Challenge Test Results in Patients With Suspected Penicillin Allergy, but No Specific IgE

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