Epidemiology of life-threatening and lethal anaphylaxis: a review

被引:268
作者
Moneret-Vautrin, DA [1 ]
Morisset, M [1 ]
Flabbee, J [1 ]
Beaudouin, E [1 ]
Kanny, G [1 ]
机构
[1] Univ Hosp, Dept Internal Med Clin Immunol & Allergol, F-54035 Nancy, France
关键词
Allergy Vigilance Network; epidemiology; lethal; life-threatening anaphylaxis;
D O I
10.1111/j.1398-9995.2005.00785.x
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Severe anaphylaxis is a systemic reaction affecting two or more organs or systems and is due to the release of active mediators from mast cells and basophils. A four-grade classification routinely places 'severe' anaphylaxis in grades 3 and 4 (death could be graded as grade 5). Studies are underway to determine the prevalence of severe and lethal anaphylaxis in different populations and the relative frequencies of food, drug, latex and Hymenoptera anaphylaxis. These studies will also analyse the risk arising from the lack of preventive measures applied in schools (personalized management protocols) and from the insufficient use of self-injected adrenalin. Allergy-related conditions may account for 0.2-1% of emergency consultations. Severe anaphylaxis affects 1-3 per 10 000 people, but for the United States and Australia figures are even higher. It is estimated to cause death in 0.65-2% of patients, i.e. 1-3 per million people. An increased prevalence has been revealed by monitoring hospitalized populations by reference to the international classification of disease (ICD) codes. The relative frequency of aetiological factors of allergy (food, drugs, insects and latex) varies in different studies. Food, drug and Hymenoptera allergies are potentially lethal. The risk of food-mediated anaphylaxis can be assessed from the number of personalized management protocols in French schools: 0.065%. Another means of assessment may be the rate of adrenalin prescriptions. However, an overestimation of the anaphylaxis risk may result from this method (0.95% of Canadian children). Data from the literature leads to several possibilities. First, a definition of severe anaphylaxis should be agreed. Secondly, prospective, multicentre enquiries, using ICD codes, should be implemented. Moreover, the high number of anaphylaxis cases for which the aetiology is not identified, and the variation in aetiology in the published series, indicate that a closer cooperation between emergency specialists and allergists is essential.
引用
收藏
页码:443 / 451
页数:9
相关论文
共 116 条
[1]   Anaphylaxis due to a tick bite [J].
Acero, S ;
Blanco, R ;
Bartolomé, B .
ALLERGY, 2003, 58 (08) :824-825
[2]  
[Anonymous], 2004, NOVARTIS FOUND SYMP
[3]  
[Anonymous], NOVARTIS FDN S
[4]   Intraoperative anaphylactic shock associated with bacitracin irrigation during revision total knee arthroplasty - A case report [J].
Antevil, JL ;
Muldoon, MP ;
Battaglia, M ;
Green, R .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2003, 85A (02) :339-342
[5]  
ANTONICELLI L, 2003, ALLERG IMMUNOL, V35, P199
[6]   Fatal anaphylactoid reaction to N-acetylcysteine: caution in patients with asthma [J].
Appelboam, AV ;
Dargan, PI ;
Knighton, J .
EMERGENCY MEDICINE JOURNAL, 2002, 19 (06) :594-595
[7]   RECURRENT ANAPHYLAXIS CAUSED BY ANISAKIS SIMPLEX PARASITIZING FISH [J].
AUDICANA, MT ;
DECORRES, LF ;
MUNOZ, D ;
FERNANDEZ, E ;
NAVARRO, JA ;
DELPOZO, MD .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1995, 96 (04) :558-560
[8]   Limpet anaphylaxis:: cross-reactivity between limpet and house-dust mite Dermatophagoides pteronyssinus [J].
Azofra, J ;
Lombardero, M .
ALLERGY, 2003, 58 (02) :146-149
[9]   Anaphylaxis to rocuronium [J].
Baillard, C ;
Korinek, AM ;
Galanton, V ;
Le Manach, Y ;
Larmignat, P ;
Cupa, M ;
Samama, CM .
BRITISH JOURNAL OF ANAESTHESIA, 2002, 88 (04) :600-602
[10]  
Bellou Abdelouahab, 2003, Emerg Med (Fremantle), V15, P341, DOI 10.1046/j.1442-2026.2003.00472.x