TY - JOUR
TI - Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry
AU - Francuzik, W.
AU - Ruëff, F.
AU - Bauer, A.
AU - Bilò, M.B.
AU - Cardona, V.
AU - Christoff, G.
AU - Dölle-Bierke, S.
AU - Ensina, L.
AU - Fernández Rivas, M.
AU - Hawranek, T.
AU - O'B Hourihane, J.
AU - Jakob, T.
AU - Papadopoulos, N.G.
AU - Pföhler, C.
AU - Poziomkowska-Gęsicka, I.
AU - Van der Brempt, X.
AU - Scherer Hofmeier, K.
AU - Treudler, R.
AU - Wagner, N.
AU - Wedi, B.
AU - Worm, M.
JO - Allergy: European Journal of Allergy and Clinical Immunology
PY - 2021
VL - 147
TODO - 2
SP - 653-662.e9
PB - Mosby Year Book Inc
SN - null
TODO - 10.1016/j.jaci.2020.06.008
TODO - antihistaminic agent;  beta adrenergic receptor blocking agent;  corticosteroid;  dipeptidyl carboxypeptidase inhibitor;  epinephrine;  insect venom;  tryptase;  arthropod venom, adult;  age;  anaphylaxis;  Article;  cardiovascular symptom;  case control study;  cohort analysis;  controlled study;  disease severity;  female;  high risk patient;  human;  major clinical study;  male;  personalized medicine;  phenotype;  priority journal;  protein blood level;  register;  risk factor;  sex;  skin manifestation;  venom induced anaphylaxis;  anaphylaxis;  child;  complication;  Europe;  insect bite;  pathophysiology;  phenotype;  risk factor, Adult;  Anaphylaxis;  Arthropod Venoms;  Case-Control Studies;  Child;  Cohort Studies;  Europe;  Female;  Humans;  Insect Bites and Stings;  Male;  Phenotype;  Registries;  Risk Factors
TODO - Background: Venom-induced anaphylaxis (VIA) is a common, potentially life-threatening hypersensitivity reaction associated with (1) a specific symptom profile, 2) specific cofactors, and 3) specific management. Identifying the differences in phenotypes of anaphylaxis is crucial for future management guidelines and development of a personalized medicine approach. Objective: This study aimed to evaluate the phenotype and risk factors of VIA. Methods: Using data from the European Anaphylaxis Registry (12,874 cases), we identified 3,612 patients with VIA and analyzed their cases in comparison with sex- and age-matched anaphylaxis cases triggered by other elicitors (non-VIA cases [n = 3,605]). Results: VIA more frequently involved more than 3 organ systems and was associated with cardiovascular symptoms. The absence of skin symptoms during anaphylaxis was correlated with baseline serum tryptase level and was associated with an increased risk of a severe reaction. Intramuscular or intravenous epinephrine was administered significantly less often in VIA, in particular, in patients without a history of anaphylaxis. A baseline serum tryptase level within the upper normal range (8-11.5 ng/mL) was more frequently associated with severe anaphylaxis. Conclusion: Using a large cohort of VIA cases, we have validated that patients with intermediate baseline serum tryptase levels (8-11 ng/mL) and without skin involvement have a higher risk of severe VIA. Patients receiving β-blockers or angiotensin-converting enzyme inhibitors had a higher risk of developing severe cardiovascular symptoms (including cardiac arrest) in VIA and non-VIA cases. Patients experiencing VIA received epinephrine less frequently than did cases with non-VIA. © 2020 American Academy of Allergy, Asthma & Immunology
ER -