Τίτλος:
Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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
Συγγραφείς:
Francuzik, W.
Ruëff, F.
Bauer, A.
Bilò, M.B.
Cardona, V.
Christoff, G.
Dölle-Bierke, S.
Ensina, L.
Fernández Rivas, M.
Hawranek, T.
O'B Hourihane, J.
Jakob, T.
Papadopoulos, N.G.
Pföhler, C.
Poziomkowska-Gęsicka, I.
Van der Brempt, X.
Scherer Hofmeier, K.
Treudler, R.
Wagner, N.
Wedi, B.
Worm, M.
Περιοδικό:
Allergy: European Journal of Allergy and Clinical Immunology
Εκδότης:
Mosby Year Book Inc
Λέξεις-κλειδιά:
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
DOI:
10.1016/j.jaci.2020.06.008
