Predictors of the Severity and Serious Outcomes of Anaphylaxis in Korean Adults: A Multicenter Retrospective Case Study

Ye, Young-Min; Kim, Mi Kyeong; Kang, Hye Ryun; Kim, Tae‐Bum; Sohn, Seong Wook; Koh, Young Il; Park, Hye Kyung; Jang, Gwang Cheon; Kim, Cheol Woo; Jee, Young Koo; Hur, Gyu Young; Kim, Joo Hee; Kim, Sang Heon; Choi, Gil Soon; Lee, Soo Keol; Park, Hae‐Sim

doi:10.4168/aair.2015.7.1.22

Cited by 78 publications

(89 citation statements)

References 24 publications

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“…These results are quite different from those of a recent study of anaphylaxis epidemiology in Korean adults, wherein most cases were induced by drugs (46.6%), food (24.2%), insect stings (16.5%), and exercise (5.9%) 6. As in this study, common anaphylaxis triggers for adults differed by age groups and geographical area.…”

Section: Discussioncontrasting

confidence: 99%

A Multicenter Retrospective Case Study of Anaphylaxis Triggers by Age in Korean Children

Lee

Ahn

Kim

et al. 2016

Allergy Asthma Immunol Res

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PurposeAlthough anaphylaxis is recognized as an important, life-threatening condition, data are limited regarding its triggers in different age groups. We aimed to identify anaphylaxis triggers by age in Korean children.MethodsWe performed a retrospective review of medical records for children diagnosed with anaphylaxis between 2009 and 2013 in 23 secondary or tertiary hospitals in South Korea.ResultsA total of 991 cases (mean age=5.89±5.24) were reported, with 63.9% involving patients younger than 6 years of age and 66% involving male children. Food was the most common anaphylaxis trigger (74.7%), followed by drugs and radiocontrast media (10.7%), idiopathic factors (9.2%), and exercise (3.6%). The most common food allergen was milk (28.4%), followed by egg white (13.6%), walnut (8.0%), wheat (7.2%), buckwheat (6.5%), and peanut (6.2%). Milk and seafood were the most common anaphylaxis triggers in young and older children, respectively. Drug-triggered anaphylaxis was observed more frequently with increasing age, with antibiotics (34.9%) and nonsteroidal anti-inflammatory drugs (17.9%) being the most common causes.ConclusionsThe most common anaphylaxis trigger in Korean children was food. Data on these triggers show that their relative frequency may vary by age.

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Section: Discussioncontrasting

confidence: 99%

A Multicenter Retrospective Case Study of Anaphylaxis Triggers by Age in Korean Children

Lee

Ahn

Kim

et al. 2016

Allergy Asthma Immunol Res

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“…Our outcomes could be related to the close geographic proximity of patients to emergency care and the high rates of adrenaline treatment (83%). Our study demonstrated that food anaphylaxis in adults was the most common type, as opposed to drug anaphylaxis seen in reports from Western [18][19][20] and some Asian [21,22] countries. Food was the most common cause of anaphylaxis in prior studies of adults in Singapore [9], China [23], and Saudi Arabia [24], and in the general population in Thailand [25] and Hong Kong [17].…”

Section: Discussionmentioning

confidence: 84%

Cause and Clinical Presentation of Anaphylaxis in Singapore: From Infancy to Old Age

Goh¹,

Soh

Loh³

et al. 2018

Int Arch Allergy Immunol

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Background: The study objective was to compare age-related differences in the cause and clinical presentation of anaphylaxis. Methods: We conducted a prospective study of patients visiting the emergency department for anaphylaxis. Data were collected from 3 emergency departments from 1 April 2014 to 31 December 2015. Patient electronic records with the diagnoses of allergy, angioedema, urticaria, and anaphylaxis (ICD-9 codes 9953, 9951, 7080, 9950, 7089) were screened and cases fulfilling World Allergy Organisation criteria for anaphylaxis were included. Results: A total of 426 cases of anaphylaxis were identified with a median age of 23 years (range 3 months to 88 years and 9 months). The causes of anaphylaxis were food (n = 236, 55%), drugs (n = 85, 20%), idiopathic (n = 64, 15%), and insect bites or stings (n = 28, 7%). The most common food was shellfish (n = 58, 14%) and the most common drugs were non-steroidal anti-inflammatory drugs (n = 26, 6%). There were more cases of food anaphylaxis in children than in adults (72 vs. 42%, p < 0.001) and more cases of drug anaphylaxis in adults than in children (28 vs. 10%, p < 0.001). Compared to patients of other ages, infants and young children had more gastrointestinal symptoms (adjusted odds ratio [aOR] 2.1, 95% CI 1.1-3.9), while schoolchildren and adolescents had more respiratory symptoms (aOR 2.7, 95% CI 1.4-5.2). Adults had more cardiovascular symptoms (aOR 2.9, 95% CI 1.8-4.6) and hypotension (aOR 3.7, 95% CI 2.1-6.8) compared to children. However, 42% of the infants lacked blood pressure measurements. Conclusions: Knowledge of age-related variation in the cause and clinical presentation of anaphylaxis aids in diagnosis and acute management.

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“…However, they are the main cause of HDRs [57], including anaphylaxis reactions [58]. NIUA is the most frequent entity in NSAID HDRs; nevertheless, genetic association studies for this pathology are scarce [2,17,59,60,61,62,63] and have not previously analyzed the role of TSLP and its receptor in this clinical entity.…”

Section: Discussionmentioning

confidence: 99%

Genetic Variants of Thymic Stromal Lymphopoietin in Nonsteroidal Anti-Inflammatory Drug-Induced Urticaria/Angioedema

Plaza-Serón

Blanca‐López²,

Pérez‐Sánchez³

et al. 2016

Int Arch Allergy Immunol

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Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most frequent agents involved in hypersensitivity drug reactions, with NSAID-induced urticaria and/or angioedema (NIUA) being the most common entity. Mast cells are key players in NIUA and are activated by thymic stromal lymphopoietin (TSLP). This cytokine functions through recognition by its receptor, composed of IL7Rα (interleukin-7 receptor alpha) and TSLPR (TSLP receptor). These genes have been previously associated with other inflammatory diseases. Methods: We assessed the genetic association between single nucleotide polymorphisms (SNPs) in TSLP, IL7R and TSLPR and NIUA in Spanish individuals, using genotyped and imputed data. A total of 369 unrelated NIUA patients and 580 NSAID-tolerant control subjects were included, and 6 SNPs in TSLP, 6 in IL7R and 3 in TSLPR were genotyped. Further variants were imputed using Mach and the 1,000 Genomes Project (Phase 3) data. Association testing and statistical analyses were performed with Mach2dat and R. Results: A total of 139 SNPs were tested for association following quality control. Two SNPs in TSLP (rs1816678 and rs764917) showed a nominal association (p = 0.033 and 0.024, respectively) with NIUA, although these results were not statistically significant after correcting for multiple comparisons. Conclusions: Although TSLP, IL7R and TSLPR are important genes involved in the development of the inflammatory response, we found no significant genetic association with NIUA in our population for common SNPs in these genes.

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Predictors of the Severity and Serious Outcomes of Anaphylaxis in Korean Adults: A Multicenter Retrospective Case Study

Cited by 78 publications

References 24 publications

A Multicenter Retrospective Case Study of Anaphylaxis Triggers by Age in Korean Children

A Multicenter Retrospective Case Study of Anaphylaxis Triggers by Age in Korean Children

Cause and Clinical Presentation of Anaphylaxis in Singapore: From Infancy to Old Age

Genetic Variants of Thymic Stromal Lymphopoietin in Nonsteroidal Anti-Inflammatory Drug-Induced Urticaria/Angioedema

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