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Anaphylaxis. A review of 266 cases
S F Kemp1, R F Lockey, B L Wolf
1Department of Internal Medicine, University of Tennessee College of Medicine, Memphis, USA.
Archives of Internal Medicine
|September 11, 1995
Summary
Recurrent anaphylaxis is common, with identifiable causes in two-thirds of patients. Those with idiopathic anaphylaxis are more likely to carry epinephrine, highlighting a need for improved self-administration education.
Area of Science:
- Allergy and Immunology
- Epidemiology
- Public Health
Background:
- Anaphylaxis is a severe allergic reaction requiring comprehensive understanding of its triggers and management.
- This study analyzes a large cohort of anaphylaxis cases to identify common causes and patient behaviors.
Purpose of the Study:
- To investigate the prevalence of atopy, common triggers, and self-management practices in a large population of anaphylaxis patients.
- To compare characteristics and epinephrine-carrying behaviors between patients with identified anaphylaxis causes and those with idiopathic anaphylaxis.
Main Methods:
- Retrospective chart review of 266 patients diagnosed with anaphylaxis between 1978 and 1992.
- Follow-up questionnaires were administered to assess triggers, recurrence, and self-administration of epinephrine.
Main Results:
- Recurrent anaphylaxis (three or more episodes) occurred in 61% of subjects.
- Commonly identified triggers included foods (crustaceans, peanuts) and medications (nonsteroidal anti-inflammatory drugs).
- Idiopathic anaphylaxis was diagnosed in 37% of cases, and these patients were more likely to carry epinephrine than those with known triggers.
Conclusions:
- Atopy is frequently observed in anaphylaxis patients, irrespective of the cause.
- Crustaceans and NSAIDs are leading food and medication triggers, respectively.
- Effective identification of causes is possible for two-thirds of patients, emphasizing the need for improved epinephrine self-administration education, particularly for those with idiopathic anaphylaxis.
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