Anaphylaxis incidence

Past history of anaphylaxis Incidence of symptom by extremely small amount... 

In principal, data on the epidemiology of anaphylaxis will help to identify causes, risk factors and circumstances of the reaction. It will support the medical commimity to develop measures for the protection of affected patients. A true incidence of anaphylaxis has not been established, reasons are diverse study designs and the fact that there has been no universal consensus as to the definition of anaphylaxis [ 1 ]. 

Smit DV, Cameron PA, Rainer TH Anaphylaxis presentation in a emergency department in Hong Kong incidence and predictors of biphasic reactions. J Emerg Med 2005 28 381-388. 

Helbling A, Hurni T, Mueller UR. Pichler WJ Incidence of anaphylaxis with circulatory symptoms a study over a 3-year period comprising 940,000 inhabitants of the Swiss Canton Bern. Clin Exp Allergy 2004 34 285-290. 

Peng MM. Jick H A population-based study of the incidence, cause, and severity of anaphylaxis in the United Kingdom. Arch Intern Med 2004 164 317-319. Bohlke K, Davis RL, DeStefano F. et al Vaccine Safety Datalink Team. Epidemiology of anaphylaxis among children and adolescents enrolled in a health maintenance organization. J Allergy Clin Immunol 2004 113 536-542. 

Decker WW, Campbell RL, Manivannan V, Luke A, St Sauver JL, Weaver A, Belloho MF, Bergstralh EJ, Stead LG, Li JT Etiology and incidence of anaphylaxis in Rochester, Minnesota a report from the Rochester Epidemiology Project. J Allergy Chn Immunol 2008 122 1161-1165. 

Sheikh A. Hippisley-Cox J. Newton J, Fenty J Trends in national incidence, lifetime prevalence and adrenaline prescribing for anaphylaxis in England. J R Soc Med 2008 101 139-143. 

The potential severity of anaphylaxis during anesthesia underscores the interest of developing a rational approach to reduce its incidence by identifying potential risk factors before surgery. Recommendations concerning the identification of population at risk of peroperative anaphylaxis, who would benefit from preoperative investigation, have been proposed [10]. 

Malinovsky JM, Decagny S. Wessel F. Guilloux L, Merles PM Systematic follow-up increases incidence of anaphylaxis during adverse reactions in anesthetized patients. Acta Anaesthesiol Scand 2008 52 175. 

Degerbeck F, Dybendal T, Lundberg M Prevalence of IgE antibodies to morphine. Relation to the high and low incidences of NMBA anaphylaxis in Norway 29 and Sweden, respectively. Acta Anaesthesiol Scand 2005 49 437. 

Ontak—watch for high incidence of acute hypersensitivity reactions be prepared to treat possible anaphylaxis ... 

Because it is associated with a 0.1% incidence of anaphylaxis, patients should remain in the physician s office for a reasonable period after the injection because 70% of reactions occur within 2 hours. Some reactions have occurred up to 24 hours after injection. 

Complications have included anaphylaxis, brain damage and even death, typically occurring at an incidence of 3-9 cases per million doses administered. 

Peng MM, Jick H. A popnlation-based stndy of the incidence, canse, and severity of anaphylaxis in the United Kingdom. Arch Int Med 2004 164(3) 317-9. 

Bronchospasm is not a direct action of these drugs but blockade of p-receptors increases the reactivity of the airway and increases the likelihood of bronchospasm during laryngoscopy and tracheal intubation. It is also possible that the severity, and possibly the incidence of acute anaphylaxis is increased in patients on large doses of 3 blockers and that resuscitation may be hampered in these circumstances. 

There is a slightly increased risk of infection (as with other biologic DMARDs), predominantly of the upper respiratory tract. Concomitant use with TNF-a antagonists is not recommended due to the increased incidence of serious infection with this combination. Infusion-related reactions and hypersensitivity reactions, including anaphylaxis, have been reported but are rare. Anti-abatacept antibody formation is infrequent (< 5%) and has no effect on clinical outcomes. The incidence of malignancies is similar to placebo with the exception of a possible increase in lymphomas. The role of abatacept in this increase is unknown. 

Insulin allergy, an immediate type hypersensitivity, is a rare condition in which local or systemic urticaria results from histamine release from tissue mast cells sensitized by anti-insulin IgE antibodies. In severe cases, anaphylaxis results. Because sensitivity is often to noninsulin protein contaminants, the human and analog insulins have markedly reduced the incidence of insulin allergy, especially local reactions. 

An early study of pharmacovigilance [46] reported that the incidence of side effects was indeed low oropharyngeal itching represented about 50% of the untoward effects, followed by rhinorrhea and constipation. Urticaria and asthma were very rare. More than 90% of the effects were mild and did not require any kind of medical treatment. No systemic anaphylaxis was reported. 

Allergic reactions, including anaphylaxis, can occur on re-exposure to aprotinin. The incidence rates of aprotinin-related reactions are 2.7% in re-exposed adults (5/183) and 1.2% in children (3/354), with an overall incidence of 1.8% (8/437). The following advice has been given to reduce the risk and severity of these reactions (1,2) ... 

The International Rheumatic Fever Study, a prospective multicenter study that recorded allergic reactions, defined as hypotension, dyspnea, pruritus, urticaria, angioedema, arthralgia, and maculopapular rash in 1790 patients treated with monthly intramuscular benzathine penicillin for prophylaxis of rheumatic fever (32 430 injections during 2736 patient years). There was a 3.2% case incidence of allergic reactions and a 0.2% case incidence of anaphylaxis (12/100000 injections), including one death (0.05%, equivalent to 3.1/ 100000 injections) (233). 

It is possible that the potential benefit of reducing the incidence of central venous sepsis by using chlorhexidine-coated catheters is outweighed by the risk of sudden and profound anaphylaxis. Certainly a high degree of suspicion of chlorhexidine allergy shonld be exercised and skin tests performed. 

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