Alexei Gonzalez-Estrada1, Stacy K Silvers2, Asaf Klein3, Katrina Zell4, Xiao-Feng Wang4, David M Lang5. 1. Department of Allergy and Immunology, Cleveland Clinic, Cleveland, Ohio. Electronic address: gonzalez.alexei@gmail.com. 2. Allergy Partners of North Texas, Dallas, Texas. 3. ACPNY, Brooklyn, New York. 4. Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio. 5. Department of Allergy and Immunology, Cleveland Clinic, Cleveland, Ohio.
Abstract
BACKGROUND: Recent data reveal that the rate of anaphylaxis is increasing and suggest that idiopathic anaphylaxis may account for most of these cases. OBJECTIVE: To determine the pattern of anaphylaxis at a tertiary care referral center. METHODS: A retrospective electronic medical record review spanning 12 years (2002-2013) identified patients with anaphylaxis. RESULTS: Of the 4,777 records reviewed, 730 patients met our anaphylaxis definition. Median age was 34.0 years; 72.7% were adults, 58.6% were female, and 86.8% were white. Median time to evaluation by an allergist was 8.8 months. Foods were the most common cause (29.9%), followed by Hymenoptera venom (24.6%), idiopathic anaphylaxis (13.7%), and medications (13.3%). The most common foods were peanuts (23.9%), tree nuts (21.6%), shellfish (16.1%), and egg and milk (both 10.1%). The most common cause of anaphylaxis in adults was Hymenoptera venom. The most frequent symptoms were urticaria and/or angioedema, reported in 84.7% of cases. Atopy was present in 43.8%. In 15.4% of cases, anaphylaxis was not the chief reason for the office visit. CONCLUSION: We found food allergy was the most common overall cause of anaphylaxis, with peanut the most frequent food trigger. Idiopathic anaphylaxis was not the most common cause but accounted for 13.7% of all cases. Approximately 1 in 6 cases of anaphylaxis may be missed if a comprehensive evaluation is not performed.
BACKGROUND: Recent data reveal that the rate of anaphylaxis is increasing and suggest that idiopathic anaphylaxis may account for most of these cases. OBJECTIVE: To determine the pattern of anaphylaxis at a tertiary care referral center. METHODS: A retrospective electronic medical record review spanning 12 years (2002-2013) identified patients with anaphylaxis. RESULTS: Of the 4,777 records reviewed, 730 patients met our anaphylaxis definition. Median age was 34.0 years; 72.7% were adults, 58.6% were female, and 86.8% were white. Median time to evaluation by an allergist was 8.8 months. Foods were the most common cause (29.9%), followed by Hymenoptera venom (24.6%), idiopathic anaphylaxis (13.7%), and medications (13.3%). The most common foods were peanuts (23.9%), tree nuts (21.6%), shellfish (16.1%), and egg and milk (both 10.1%). The most common cause of anaphylaxis in adults was Hymenoptera venom. The most frequent symptoms were urticaria and/or angioedema, reported in 84.7% of cases. Atopy was present in 43.8%. In 15.4% of cases, anaphylaxis was not the chief reason for the office visit. CONCLUSION: We found food allergy was the most common overall cause of anaphylaxis, with peanut the most frequent food trigger. Idiopathic anaphylaxis was not the most common cause but accounted for 13.7% of all cases. Approximately 1 in 6 cases of anaphylaxis may be missed if a comprehensive evaluation is not performed.
Authors: Bo Young Chung; Ji Young Um; Jin Cheol Kim; Seok Young Kang; Min Je Jung; Hye One Kim; Chun Wook Park Journal: Medicina (Kaunas) Date: 2020-12-14 Impact factor: 2.430
Authors: Christine Y Y Wai; Nicki Y H Leung; Ka Hou Chu; Patrick S C Leung; Agnes S Y Leung; Gary W K Wong; Ting Fan Leung Journal: Int J Mol Sci Date: 2020-03-23 Impact factor: 5.923