Comorbidities and Cofactors of Anaphylaxis in Patients with Moderate to Severe Anaphylaxis. Analysis of Data from the Anaphylaxis Registry for West Pomerania Province, Poland.

Iwona Poziomkowska-Gęsicka,Magdalena Kostrzewska,Michał Kurek

doi:10.3390/ijerph18010333

Abstract

Anaphylaxis is a severe, potentially life-threatening systemic hypersensitivity reaction that is still rarely diagnosed. For safety reasons, patients should visit an allergologist to identify potential causes and cofactors of this reaction. This paper presents the analysis of data from the Anaphylaxis Registry gathered over ten years at the Allergy Clinic, Pomeranian Medical University (PMU). A questionnaire-based survey was used for patients visiting the Allergy Clinic to identify potential augmentation factors/comorbidities and/or cofactors of anaphylaxis in patients with a history of moderate to severe anaphylaxis. The registry comprised patients with grade II or higher anaphylaxis. The gathered data concerned chronic comorbidities (cardiovascular diseases, respiratory diseases, and others), recurrence of anaphylaxis, and potential cofactors in anaphylaxis. In the analyzed group, the incidence rate of anaphylaxis was the highest for women aged 19–60 years. Most common comorbidities in patients with moderate to severe anaphylaxis included: cardiovascular diseases, respiratory tract diseases, features of atopy, and thyroid diseases. More than 30% of drug-induced reactions were anaphylactic reactions due to the re-exposure to the same drug, which points to the need for educational initiatives in this area. The incidence rate of anaphylaxis induced by Hymenoptera stings was comparable in patients who had a previous generalized reaction and those who had good tolerance to the previous sting. It is important to take these cofactors into consideration when evaluating patients with anaphylaxis as they may play a role in future anaphylactic reactions.

Highlights

The term anaphylaxis was used for the first time in 1902 by Portier and Richet to describe a reaction opposite to prophylaxis
Of all 10,738 new patients examined at the Allergology Department in 2006–2015, there were 382 cases of moderate and severe anaphylaxis, which accounted for 3.56% of new patients
Most patients with moderate to severe anaphylaxis were in the age range 19–40 and 41–60 years, which accounted for about 75% of all anaphylactic reactions in the registry

Summary

Introduction

The term anaphylaxis was used for the first time in 1902 by Portier and Richet to describe a reaction opposite to prophylaxis. They described an experiment on dogs that had tolerated a certain dose of a jellyfish toxin, but after the injection of a lower dose of the same toxin, the dogs reacted with bronchospasm and cardiorespiratory arrest and died [1]. Different definitions of anaphylaxis have been proposed since the first use of this term—Table 1. Contemporary definitions are presented in a paper by Turner in 2019 [2]. A serious allergic reaction that is rapid in onset and might cause death

Methods

Results

Conclusion