Anaphylaxis in a Swiss university emergency department: clinical characteristics and supposed triggers.

Ehrhard, Simone; Eyb, Vicky; Gautschi, Dominic; Schauber, Stefan K; Ricklin, Meret E; Klukowska-Rötzler, Jolanta; Exadaktylos, Aristomenis K; Helbling, Arthur (2024). Anaphylaxis in a Swiss university emergency department: clinical characteristics and supposed triggers. Allergy, asthma & clinical immunology, 20(35) B.C. Decker Inc. 10.1186/s13223-024-00901-y

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BACKGROUND

Anaphylaxis is the most severe form of acute systemic and potentially life-threatening reactions triggered by mast and basophilic cells. Recent studies show a worldwide incidence between 50 and 112 occurrences per 100,000 person-years. The most identified triggers are food, medications, and insect venoms. We aimed to analyze triggers and clinical symptoms of patients presenting to a Swiss university emergency department for adults.

METHODS

Six-year retrospective analysis (01/2013 to 12/2018) of all patients (> 16 years of age) admitted with moderate or severe anaphylaxis (classification of Ring and Messmer ≥ 2) to the emergency department. Patient and clinical data were extracted from the electronic medical database of the emergency department.

RESULTS

Of the 531 includes patients, 53.3% were female, the median age was 38 [IQR 26-51] years. The most common suspected triggers were medications (31.8%), food (25.6%), and insect stings (17.1%). Organ manifestations varied among the different suspected triggers: for medications, 90.5% of the patients had skin symptoms, followed by respiratory (62.7%), cardiovascular (44.4%) and gastrointestinal symptoms (33.7%); for food, gastrointestinal symptoms (39.7%) were more frequent than cardiovascular symptoms (36.8%) and for insect stings cardiovascular symptoms were apparent in 63.8% of the cases.

CONCLUSIONS

Average annual incidence of moderate to severe anaphylaxis during the 6-year period in subjects > 16 years of age was 10.67 per 100,000 inhabitants. Medications (antibiotics, NSAID and radiocontrast agents) were the most frequently suspected triggers. Anaphylaxis due to insect stings was more frequently than in other studies. Regarding clinical symptoms, gastrointestinal symptoms need to be better considered, especially that initial treatment with epinephrine is not delayed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Ehrhard, Simone, Eyb, Vicky, Klukowska-Rötzler, Jolanta, Exadaktylos, Aristomenis, Helbling, Arthur

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1710-1484

Publisher:

B.C. Decker Inc.

Language:

English

Submitter:

Pubmed Import

Date Deposited:

03 Jun 2024 09:46

Last Modified:

03 Jun 2024 09:54

Publisher DOI:

10.1186/s13223-024-00901-y

PubMed ID:

38822425

Uncontrolled Keywords:

Allergic reaction Anaphylaxis Emergency medicine Symptoms Triggers

BORIS DOI:

10.48350/197448

URI:

https://boris.unibe.ch/id/eprint/197448

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