Han-Ki Park1, Min-Gyu Kang2, Min-Suk Yang3, Jae-Woo Jung4, Sang-Heon Cho5, Hye-Ryun Kang6. 1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea; Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea. 2. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea; Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, South Korea. 3. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea; Department of Internal Medicine, Seoul National University Hospital Boramae Medical Center, Seoul, South Korea. 4. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea; Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea. 5. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea. 6. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea. Electronic address: helenmed@snu.ac.kr.
Abstract
BACKGROUND: Epidemiology and risk factors of drug-induced anaphylaxis are difficult to estimate due to lack of confirmative diagnosis and under reporting. Here we report the current state of drug-induced anaphylaxis in Korea based on an in-hospital pharmacovigilance database in a tertiary hospital. METHODS: This study is a retrospective analysis of drug-induced anaphylaxis, reported to an in-hospital pharmacovigilance center in Seoul National University Hospital from June 2009 to May 2013. Anaphylaxis occurred in patients under 18 years of age or developed by medications administered from outside pharmacies or hospitals were excluded. We assessed causative drug, incidence per use of each drug and risk factors of fatal anaphylactic shock. RESULTS: A total of 152 in-hospital drug-induced anaphylaxis cases were reported during the study period. The single most frequently reported drug was platinum compound and the incidence of anaphylaxis and anaphylactic shock in platinum compounds users was 2.84 and 1.39 per 1000 patients use. Risk factors of anaphylactic shock among total anaphylaxis cases were identified as older age ≥70 years [Odd's ratio (OR), 5.86; 95% confidence interval (CI), 1.70-20.14]. The use of iodinated contrast media (OR, 6.19; 95% CI, 1.87-20.53) and aminosteroid neuromuscular blocking agent (NMBA) (OR, 12.82; 95% CI, 1.50-109.92) were also a risk factor for the development of anaphylactic shock. CONCLUSIONS: Platinum compounds are the most commonly reported causative agents of in-hospital drug-induced anaphylaxis. Older age ≥70 years and drugs such as iodinated contrast media and aminosteroid NMBA are related with high risk of anaphylactic shock.
BACKGROUND: Epidemiology and risk factors of drug-induced anaphylaxis are difficult to estimate due to lack of confirmative diagnosis and under reporting. Here we report the current state of drug-induced anaphylaxis in Korea based on an in-hospital pharmacovigilance database in a tertiary hospital. METHODS: This study is a retrospective analysis of drug-induced anaphylaxis, reported to an in-hospital pharmacovigilance center in Seoul National University Hospital from June 2009 to May 2013. Anaphylaxis occurred in patients under 18 years of age or developed by medications administered from outside pharmacies or hospitals were excluded. We assessed causative drug, incidence per use of each drug and risk factors of fatal anaphylactic shock. RESULTS: A total of 152 in-hospital drug-induced anaphylaxis cases were reported during the study period. The single most frequently reported drug was platinum compound and the incidence of anaphylaxis and anaphylactic shock in platinum compounds users was 2.84 and 1.39 per 1000 patients use. Risk factors of anaphylactic shock among total anaphylaxis cases were identified as older age ≥70 years [Odd's ratio (OR), 5.86; 95% confidence interval (CI), 1.70-20.14]. The use of iodinated contrast media (OR, 6.19; 95% CI, 1.87-20.53) and aminosteroid neuromuscular blocking agent (NMBA) (OR, 12.82; 95% CI, 1.50-109.92) were also a risk factor for the development of anaphylactic shock. CONCLUSIONS:Platinum compounds are the most commonly reported causative agents of in-hospital drug-induced anaphylaxis. Older age ≥70 years and drugs such as iodinated contrast media and aminosteroid NMBA are related with high risk of anaphylactic shock.
Authors: Sun Young Lee; Seung Chul Lee; Sang Do Shin; Kyoung Jun Song; Young Sun Ro; Jeong Ho Park; So Yeon Kong Journal: PLoS One Date: 2018-03-26 Impact factor: 3.240
Authors: Cheol Won Hyeon; Ji Young Lee; SeungGyeong Jang; Soo Ick Cho; SoYoon Kim; Won Lee; SuHwan Shin Journal: Medicine (Baltimore) Date: 2019-06 Impact factor: 1.817