Glucocorticoids for the treatment of anaphylaxis

Choo, Karen Jui Lin; Simons, F. Estelle R.; Sheikh, Aziz

doi:10.1002/ebch.1925

Cited by 52 publications

(48 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The role of steroids to prevent biphasic anaphylaxis needs further investigation [33]. In the Cochrane Reviews, the effect of steroids on anaphylaxis was not evaluated because of lack of a randomized study [34]. In our study, the median time for administration of the second dose of adrenaline was 45 min after the first dose.…”

Section: Discussionmentioning

confidence: 90%

Risk Factors for Severe Reactions during Double-Blind Placebo-Controlled Food Challenges

Yanagida¹,

Sato

Asaumi³

et al. 2017

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Background: Severe anaphylactic symptoms can occur during oral food challenges (OFCs). Thus, high-risk patients (e.g., patients with a history of anaphylaxis or high antigen-specific immunoglobulin E [IgE] levels) must carefully undergo OFCs in hospitals. We attempted to identify the risk factors for severe symptoms during OFC testing among high-risk patients. Methods: We retrospectively evaluated patients' characteristics and severe symptoms that were experienced during a double-blind placebo-controlled food challenge test performed before the patients underwent oral immunotherapy between June 2008 and June 2012. Patients were ≥5 years old and had an anaphylactic history or antigen-specific IgE (>30 kUA/L). Severe symptoms were defined using the grading of the Japanese Anaphylaxis Guidelines, which are modified from the European Academy of Allergology and Clinical Immunology Guidelines. Results: We evaluated 393 cases with positive test results, including 98 cases with severe symptoms. The most frequent severe symptoms were respiratory (77%), gastrointestinal (28%), cardiovascular (27%), and neurological (13%) symptoms. Multivariate analysis revealed that the significant factors for a severe reaction were a history of anaphylaxis to the causative food (adjusted odds ratio [OR]: 2.147, p = 0.003), older age (per 1 year increase, adjusted OR: 1.102, p = 0.044), and an egg OFC (adjusted OR: 0.433, p = 0.003). Conclusions: The risk factors for a severe reaction to OFCs were a history of an anaphylactic reaction and older age. An egg OFC was associated with low risk of severe symptoms during OFC. Therefore, OFCs for patients with these risk factors should only be performed under specialist supervision with access to rapid treatment and full resuscitation equipment.

show abstract

Section: Discussionmentioning

confidence: 90%

Risk Factors for Severe Reactions during Double-Blind Placebo-Controlled Food Challenges

Yanagida¹,

Sato

Asaumi³

et al. 2017

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…Although glucocorticoids are frequently used as an adjunctive therapy for anaphylaxis, evidence is lacking to support clinical benefit, and they should not be administered in place of epinephrine in the treatment of acute anaphylaxis. 33,34 Biphasic anaphylaxis is recurrent anaphylaxis occurring 1 to 72 hours after resolution of an initial anaphylactic episode, though an outside limit of 78 hours has also been suggested. 35,36 Estimates of biphasic anaphylaxis vary from <1% to 20% of patients; however, the ability of antihistamines and glucocorticoids to affect this outcome is unclear.…”

Section: Executive Summarymentioning

confidence: 99%

Anaphylaxis—a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis

Contributors

Reviewers

2020

Journal of Allergy and Clinical Immunology

518

489

View full text Add to dashboard Cite

show abstract

“…The concomitant administration of anti-H 2 antihistamines has not proved to have greater therapeutic efficacy and is therefore not recommended in guidelines. -Corticosteroids: Corticosteroids are used for the control of bronchospasm and prevention of biphasic reactions [28,54,59,65], even if there are no controlled studies to confirm their effectiveness in the treatment of acute anaphylactic reaction (strength of recommendation, D) [68]. The recommended drugs are intravenous hydrocortisone 200 mg in adults (in children up to 100 mg) or intravenous methylprednisolone of administration than the syringe-based system.…”

Section: Treatment Of Acute Reactionsmentioning

confidence: 99%

Hymenoptera Venom Allergy: Management of Children and Adults in Clinical Practice

Bilò

Pravettoni

Bignardi

et al. 2019

J Investig Allergol Clin Immunol

115

View full text Add to dashboard Cite

Hymenoptera venom allergy is an epidemiologically underestimated condition representing an important cause of morbidity worldwide. Preventing future allergic reactions in patients who have developed a systemic reaction is based on the correct management of emergency followed by a correct diagnosis, prescription of adrenaline autoinjectors and, where indicated, specific venom immunotherapy (VIT). Some epidemiological studies highlight the poor knowledge of this disease and the frequent inadequacy of its management. Moreover, they emphasize the importance of such a life-saving treatment as specific immunotherapy. The availability of high quality Hymenoptera venom extracts for diagnostic and therapeutic use has dramatically improved the prognosis and the quality of life of allergic patients. The subcutaneous VIT represents the most effective form of immunotherapy with allergen presently available, with a carry-over effect lasting up to several years after its interruption. This report on the management of children and adults allergic to Hymenoptera venom was drawn up by a panel of Italian experts. The main objective of this consensus is to review the scientific evidences related to diagnosis, therapy and management of patients allergic to Hymenoptera venom and is aimed to improve the knowledge about this disease and promote good clinical practices. Practical suggestions for a correct diagnosis, prescription of emergency therapy and immunotherapy, as well as strategies for taking care of patients´ management are included.

show abstract

Glucocorticoids for the treatment of anaphylaxis

Abstract: We are, based on this review, unable to make any recommendations for the use of glucocorticoids in the treatment of anaphylaxis.

Cited by 52 publications

References 62 publications

Risk Factors for Severe Reactions during Double-Blind Placebo-Controlled Food Challenges

Risk Factors for Severe Reactions during Double-Blind Placebo-Controlled Food Challenges

Anaphylaxis—a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis

Hymenoptera Venom Allergy: Management of Children and Adults in Clinical Practice

Contact Info

Product

Resources

About