Fatal and near-fatal anaphylaxis: The Allergy-Vigilance® Network data (2002-2020)

Area of Science:

• Allergy and Immunology
• Clinical Medicine
• Public Health

Background:

• Understanding risk factors for severe anaphylaxis is critical for effective physician management.
• Anaphylaxis remains a significant clinical challenge requiring detailed risk factor analysis.

Purpose of the Study:

• To retrospectively analyze severe (grade 4) anaphylaxis cases.
• To identify characteristics associated with survival, age, and specific allergens in anaphylaxis.

Main Methods:

• Analysis of 3510 anaphylaxis cases from the Allergy-Vigilance® Network (2002-2020).
• Evaluation of patient demographics, allergen types, comorbidities, and outcomes (survival/death).

Main Results:

• 70 cases of severe anaphylaxis were identified, with 25 deaths (19 food-related).
• Food allergens were primary triggers in younger patients and those with asthma history.
• Adults with severe anaphylaxis were older and more likely to have cofactors identified.
• Younger age and bronchospasm were associated with fatal outcomes.

Conclusions:

• Severe food anaphylaxis presents distinct features, including young age and asthma history.
• Adults are also susceptible to severe food-induced anaphylaxis and require careful consideration.
• Gaps in anaphylaxis prevention and management were observed, highlighting areas for improvement.