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Do Corticosteroids Prevent Biphasic Anaphylaxis?

Waleed Alqurashi1, Anne K Ellis2

  • 1Division of Emergency Medicine, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.

The Journal of Allergy and Clinical Immunology. in Practice
|September 11, 2017
PubMed
Summary
This summary is machine-generated.

Biphasic anaphylaxis, a recurrence of symptoms, may be linked to severe reactions or delayed epinephrine. Corticosteroids are not recommended for routine use due to adverse effects and lack of proven benefit in preventing biphasic anaphylaxis.

Keywords:
AnaphylaxisBiphasic anaphylaxisCorticosteroidsEpinephrine

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Area of Science:

  • Allergy and Immunology
  • Emergency Medicine
  • Pharmacology

Background:

  • Anaphylaxis is a severe, rapid hypersensitivity reaction with potential for biphasic or delayed recurrence.
  • Corticosteroids are often used in anaphylaxis treatment, but their efficacy in preventing biphasic reactions is not well-established.

Purpose of the Study:

  • To systematically analyze the role of corticosteroids in preventing biphasic anaphylaxis.
  • To evaluate the evidence for corticosteroid use in managing anaphylaxis and its recurrence.

Main Methods:

  • A comprehensive literature search was conducted across major databases (Ovid MEDLINE, EMBASE, Web of Science, Scopus).
  • Keywords included "anaphylaxis," "biphasic," "corticosteroids," and "epinephrine."
  • 31 relevant studies were identified and analyzed.

Main Results:

  • Biphasic anaphylactic reactions are more common in moderate to severe cases or when epinephrine treatment is delayed.
  • Current evidence does not compellingly support the use of corticosteroids in reducing anaphylaxis severity or preventing biphasic reactions.
  • Potential detrimental adverse effects of corticosteroids were noted.

Conclusions:

  • Routine use of corticosteroids in anaphylaxis management is not advocated.
  • Timely epinephrine administration is crucial for managing anaphylaxis and potentially reducing biphasic reactions.
  • Further research may be needed to clarify the role of adjunctive therapies in anaphylaxis.