Drug-Induced Anaphylaxis in Latin American Countries

Járes, Edgardo; Baena-Cagnani, Carlos E.; Sánchez‐Borges, Mario; Ensina, Luis Felipe; Arias-Cruz, Alfredo; Gómez, Maximiliano; Cuello, Mabel Noemi; Morfín-Maciel, Blanca María; Falco, Alicia De; Barayazarra, Susana; Bernstein, Jonathan A.; Serrano, Carlos; Monsell, Silvana; Schuhl, Juan F.; Cardona-Villa, Ricardo; Zanacchi, Viviana Andrea; Chérrez, Ivan; Salvatierra, Adolfo; Díez, Susana; Toche, Paola; Díaz, Sandra González; Felix, Mara Morelo Rocha; Zuloaga, Luis Fernando Ramírez; Vinuesa, Miguel Ángel Troitiño; Bissinger, Ingrid; Zuluaga, Luis Fernando Ramírez; Weisz, Adriana; Méndez, Ada Castillo; Mercovich, Gregorio; Piza, Cristina Frias Sartorelli de Toledo; Castillo, Ana Sofía Del; Alcaraz, P; Herrera, Eugenia; Malaman, Maria Fernanda; Mimessi, Galie

doi:10.1016/j.jaip.2015.05.012

Cited by 71 publications

(81 citation statements)

References 52 publications

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“…Although other studies showed no such significant association between atopy and anaphylaxis [39, 40], atopy was frequently visualized as a risk factor that might worsen the clinical outcome of anaphylaxis [8, 18, 19, 21, 24, 41–43]. However, several studies stated that anaphylaxis was common among patients with atopic diseases.…”

Section: Discussionmentioning

confidence: 99%

Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study

Abunada

Al‐Nesf

Thalib

et al. 2018

World Allergy Organization Journal

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BackgroundAnaphylaxis is a serious allergic disease that may lead to death if not immediately recognized and treated. Triggers of anaphylaxis including food, drugs, and insect stings can vary widely. The incidence of anaphylaxis seems to be affected by age, sex, atopy, and geographic location. This study aims to examine the common triggers of anaphylaxis in Qatar.MethodsA total of 1068 electronic medical records were audited using power chart system: 446 from the medical coding system of anaphylaxis and 622 from the epinephrine auto-injectors (EAIs) dispensed during January 2012–December 2017.ResultsOf 1068 patients, 574 (53.5%) had anaphylaxis; male to female ratio was 1.2, and 300 patients (77.9%) were less than 10 years old. The common triggers were food (n = 316, 55.0%), insect stings (n = 161, 28.0%), and drugs (n = 103, 17.9%). Common anaphylaxis food triggers were nuts (n = 173, 30.1%), eggs (n = 89, 15.5%), and seafood (n = 72, 12.5%), and common anaphylaxis medication triggers were antibiotics (n = 49, 8.5%) and nonsteroidal anti-inflammatory drugs (n = 30, 5.2%). Interestingly, 135 anaphylactic patients (23.5%) were due to black ant stings. The anaphylaxis triggers varied significantly between children and adults. Among children (less than 10 years), three quarters of the events were triggered by food (223, 74.3%) while among adults (20–55 years), insect stings (n = 59, 43.0%) and drugs (n = 44, 32.0%) were dominant.DiscussionThis is the first national study stratifying anaphylaxis triggers among different age groups in Qatar. This study will serve as a guide for clinical practice in allergy clinics in Qatar and will help to assess future trends of anaphylaxis in Qatar.Electronic supplementary materialThe online version of this article (10.1186/s40413-018-0200-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study

Abunada

Al‐Nesf

Thalib

et al. 2018

World Allergy Organization Journal

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“…However, Aun et al [13] and Faria et al [14] reported that anaphylaxis did not differ among different causative types of drugs such as NSAIDs, β-lactams, non-β-lactam antibiotics, or general anesthetics but they did not compare an anaphylaxis group with nonanaphylaxis patients. In another study performed in Latin America, the authors observed that drug-induced anaphylaxis was less severe in atopic patients, but they also did not compare anaphylaxis with nonanaphylaxis [15]. Their study bears a resemblance to ours by comparing anaphylaxis to nonanaphylactic immediate-type HRs (less severe than anaphylaxis) in terms of severity [15].…”

Section: Discussionmentioning

confidence: 93%

“…In another study performed in Latin America, the authors observed that drug-induced anaphylaxis was less severe in atopic patients, but they also did not compare anaphylaxis with nonanaphylaxis [15]. Their study bears a resemblance to ours by comparing anaphylaxis to nonanaphylactic immediate-type HRs (less severe than anaphylaxis) in terms of severity [15]. We observed that atopy increased the anaphylaxis risk 2-fold but was not associated with specific groups of drugs such as β-lactams or NSAIDs; there was a different association when we excluded non-IgE-mediated NSAID HRs.…”

Section: Discussionmentioning

confidence: 99%

“…The most common causes of anaphylaxis in adult patients are medications and venom [7-10]. Amongst causative drugs, the most common triggering ones are nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics [9-15]. It has been estimated that the incidence of drug-induced anaphylaxis and biphasic or resistant anaphylaxis are 0.04–3.1 and 10%, respectively [16-19].…”

Section: Introductionmentioning

confidence: 99%

“…Older age, intravenous administration, African-American ethnicity, and decreased platelet-activating factor acetylhydrolase activity are the factors associated with fatal drug-induced anaphylaxis [11, 21, 22]. Up to now, the role of atopy [13-15, 23, 24] and the basal serum tryptase level [25-29] in drug-induced anaphylaxis has remained controversial. Moreover, in a study investigating the HR to quinolone, the authors observed that a high total IgE level was associated with anaphylaxis [30].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Potential Risk Factors for Drug-Induced Anaphylaxis in Adult Patients

Demir¹,

Erdenen²,

Gelincik

et al. 2018

Int Arch Allergy Immunol

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Aim: To investigate the potential risk factors in patients who have experienced anaphylaxis from drugs. Method: The study included 281 adult patients (median age 40 years; 76.5% female) who experienced immediate types of hypersensitivity reaction to a drug. The patients were divided into an anaphylaxis group and a nonanaphylaxis group. The anaphylaxis group was diagnosed according to the criteria of the World Allergy Organization. Skin testing with culprit drugs was performed. In the nonanaphylaxis group, drug provocation tests were performed with culprit drugs, including aspirin or diclofenac, to determine nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity. Atopy was determined by skin prick tests with the common inhalant allergens. Patients’ demographics, clinical features, and baseline tryptase and total IgE levels were compared between the 2 groups. Results: The median interval between the last reaction in the patient’s history and the study evaluation was 7 months (range 1–120 months). In 52.3% of the patients, reactions were defined as anaphylaxis. The most common culprit drugs were NSAIDs (56.9%) and β-lactams (34.7%). The culprit drugs were used parenterally in 13.2% of the patients. 34.9% of the patients had comorbid diseases and 24.6% used additional drugs, the most common being antihypertensives (10%). Atopy was determined in 28.8% and 28.1% of the patients were smokers. The median serum level of baseline tryptase and total IgE was 3.5 µg/L and 77 kU/L, respectively. In 46.3% of the patients, skin tests with culprit drugs were positive and the positivity ratio was higher in the anaphylaxis group (p = 0.002). Anapyhlaxis was more common in patients who were: hypertensive, atopic, using angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and received the culprit drug parenterally (p = 0.034, p = 0.04, p = 0.03, p = 0.035, p = 0.013, and p < 0.001). In the multivariate analysis, it was observed that the parenteral usage of the drug and the presence of atopy were significantly higher in the anaphylaxis group (p < 0.001, odds ratio [OR] = 20.05, confidence interval [CI] 4.75–88.64; p = 0.012, OR = 2.1, CI 1.17–3.74). Age, smoking, family history, and serum levels of baseline tryptase and total IgE did not differ between groups. Conclusion: The parenteral route and atopy increase the risk of drug-induced anaphylaxis. IgE-mediated sensitivity to the culprit drug seems to facilitate anaphylaxis.

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Diagnostik von Arzneimittelallergien und -intoleranzen bei Kindern und Jugendlichen

Walter

Neustädter

2023

Dermatologie

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Drug-Induced Anaphylaxis in Latin American Countries

Cited by 71 publications

References 52 publications

Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study

Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study

Evaluation of the Potential Risk Factors for Drug-Induced Anaphylaxis in Adult Patients

Diagnostik von Arzneimittelallergien und -intoleranzen bei Kindern und Jugendlichen

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