Guideline for acute therapy and management of anaphylaxis

Ring, Johannes; Beyer, Kirsten; Biedermann, Tilo; Bircher, Andreas J.; Duda, D.; Fischer, Jörg; Friedrichs, Frank; Fuchs, Thomas; Gieler, Uwe; Jakob, Thilo; Klimek, Ludger; Lange, Lars; Merk, Hans F.; Niggemann, B.; Pfaar, Oliver; Przybilla, Bernhard; Ruëff, Franziska; Rietschel, Ernst; Schnadt, Sabine; Seifert, Roland; Sitter, H.; Varga, Eva‐Maria; Worm, Margitta; Brockow, Knut

doi:10.1007/s40629-014-0009-1

Cited by 207 publications

(130 citation statements)

References 64 publications

(54 reference statements)

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“…Concordant with the guidelines the patient received 0.5 mg intramuscular epinephrine, a cumulative dose of 1,000 mg of intravenous prednisolone and 2 mL of clemastine [7]. She received prompt intravenous fluid replacement and oxygen supplementation via a mask.…”

Section: Case Reportmentioning

confidence: 99%

A Case of Severe Anaphylaxis to Polyhexanide: Cross-Reactivity between Biguanide Antiseptics

Schunter

Stöcker²

2017

Int Arch Allergy Immunol

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We present the case of a 77-year-old female patient who suffered from severe anaphylaxis during wound care. Allergologic evaluation yielded specific IgE antibodies to chlorhexidine, but anaphylaxis to chlorhexidine was not congruent with the patient history and dermal provocation tests. However, skin prick tests provided evidence for a sensitization to polyhexanide that was further supported by the detection of specific IgE antibodies to polyhexanide, the results of basophil activation tests and IgE inhibition analysis. We presume cross-reactive IgE antibodies binding to both biguanide antiseptics and identified polyhexanide as the likely cause of the anaphylactic reaction. We recognize polyhexanide as an emerging allergen that has to be considered as a cause of anaphylaxis.

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Section: Case Reportmentioning

confidence: 99%

A Case of Severe Anaphylaxis to Polyhexanide: Cross-Reactivity between Biguanide Antiseptics

Schunter

Stöcker²

2017

Int Arch Allergy Immunol

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“…Wheals and redness reactions were measured 30 minutes after each injection and recorded by the patient in a diary on the next 3 evenings. SRs were classified according to the German anaphylaxis guideline 10. Investigators issued 3 tablets of rescue medication (cetirizine dihydrochloride, 10 mg per os, once daily) at each visit to all patients to relieve mild local reactions after injections if necessary.…”

Section: Methodsmentioning

confidence: 99%

A randomized, double‐blind, placebo‐controlled, dose‐finding trial with Lolium perenne peptide immunotherapy

Mösges

Kasche

Raskopf

et al. 2017

Allergy

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BackgroundA novel subcutaneous allergen immunotherapy formulation (gpASIT+™) containing Lolium perenne peptides (LPP) and having a short up‐dosing phase has been developed to treat grass pollen–induced seasonal allergic rhinoconjunctivitis. We investigated peptide immunotherapy containing the hydrolysate from perennial ryegrass allergens for the optimum dose in terms of clinical efficacy, immunogenicity and safety.MethodsThis prospective, double‐blind, placebo‐controlled, phase IIb, parallel, four‐arm, dose‐finding study randomized 198 grass pollen–allergic adults to receive placebo or cumulative doses of 70, 170 or 370 μg LPP. All patients received weekly subcutaneous injections, with the active treatment groups reaching assigned doses within 2, 3 and 4 weeks, respectively. Efficacy was assessed by comparing conjunctival provocation test (CPT) reactions at baseline, after 4 weeks and after completion. Grass pollen–specific immunoglobulins were analysed before and after treatment.ResultsConjunctival provocation test (CPT) response thresholds improved from baseline to V7 by at least one concentration step in 51.2% (170 μg; P = .023), 46.3% (370 μg), and 38.6% (70 μg) of patients receiving LPP vs 25.6% of patients receiving placebo (modified per‐protocol set). Also, 39% of patients in the 170‐μg group became nonreactive to CPT vs 18% in the placebo group. Facilitated allergen‐binding assays revealed a highly significant (P < .001) dose‐dependent reduction in IgE allergen binding across all treatment groups (70 μg: 17.1%; 170 μg: 18.8%; 370 μg: 26.4%). Specific IgG4 levels increased to 1.6‐fold (70 μg), 3.1‐fold (170 μg) and 3.9‐fold (370 μg) (mPP).ConclusionThree‐week immunotherapy with 170 μg LPP reduced CPT reactivity significantly and increased protective specific antibodies.

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“…Anaphylaxieauslöser bei Kindern und Erwachsenen [4]. Auslöser Kinder Erwachsene Nahrungsmittel (%) 58 16…”

Section: Tabelleunclassified

“…Arzneimittel (%) 8 21 Histamin ist der wichtigste Mediator der Anaphylaxie, aber auch PAF spielt eine zentrale Rolle [4,10]. Darüber hinaus existieren zahlreiche weitere verstärkende und hemmende Mediatoren [4, 7 -9].…”

Section: Tabelleunclassified

Anaphylaxie

Blumenstiel¹,

Bohn²

2014

Notf.med. up2date

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Guideline for acute therapy and management of anaphylaxis

Cited by 207 publications

References 64 publications

A Case of Severe Anaphylaxis to Polyhexanide: Cross-Reactivity between Biguanide Antiseptics

A Case of Severe Anaphylaxis to Polyhexanide: Cross-Reactivity between Biguanide Antiseptics

A randomized, double‐blind, placebo‐controlled, dose‐finding trial with Lolium perenne peptide immunotherapy

Anaphylaxie

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