Anaphylaxis Shock Research Articles

Knowledge and Awareness of Anaphylaxis and Anaphylactic Shock Among the General Population of the Western Region of Saudi Arabia.

Introduction Anaphylactic shock is a severe and acute life-threatening condition triggered by exposure to common allergens. Despite the increasing incidence of anaphylaxis worldwide, there is still a lack of awareness and understanding of anaphylaxis and its proper management. Methods A descriptive survey design was used to evaluate the knowledge and awareness of anaphylactic shock among the general population in the western region of Saudi Arabia through an online questionnaire distributed from January 2024 to June 2024. The validated questionnaire included demographic information and 18 knowledge-based questions on anaphylaxis. Results The data was collected from 501 participants in the western region of Saudi Arabia. Among them, 290 (58%) were female, and 211 (42%) were male. The largest age group was between 41 and 50 years, comprising 121 participants (24.1%). Additionally, most participants, 298 (59.4%), held a bachelor's degree. A total of 207 participants (41.3%) reported either experiencing anaphylaxis or knowing someone who had. Furthermore, 123 participants (24.5%) underwent tests for anaphylaxis or anaphylactic shock, with 88 (17.5%) having a blood test and 35 (7%) having a skin prick test. In terms of knowledge about anaphylaxis, 266 participants (53%) were able to accurately identify multiple symptoms, while 195 (38.9%) were uncertain about the proper diagnostic methods. Moreover, only 92 (18.4%) recognized epinephrine as the first-line treatment, and 125 (25%) knew the correct administration route (intramuscular). 216 participants (43.1%) were aware of the need to visit the ER after using epinephrine. Furthermore, the survey findings indicated that 318 participants (63.5%) acknowledged the dangerous nature of anaphylaxis, with 258 (51.5%) believing that it could be fatal. However, 228 (45.5%) remained unsure about the risk of anaphylaxis-associated organ failure. Conclusion The study highlighted the need for targeted public awareness campaigns to improve understanding and ensure early recognition and correct management of anaphylaxis.

Incidence, predictors, and treatment outcomes of biphasic anaphylaxis in the emergency department of a tertiary hospital:A 5-year retrospective study.

Biphasic anaphylaxis despite successful treatment has an incidence of 4-5% based on NIAID/FAAN criteria. Our study aimed to investigate the frequency and predictive factors associated with biphasic reactions within the emergency department (ED) at Siriraj Hospital. This observational study assessed medical records of anaphylaxis and anaphylactic shock patients at Siriraj Hospital's ED from January 2015 to December 2019. Of these, a random sample was reviewed and validated by allergists. Telephone interviews were performed to collect more data. Uni- or biphasic response were analyzed descriptively. Prediction modeling was performed. Among 1888 ED anaphylaxis cases, 601 were randomly sampled; 239 patients completing interviews were analyzed. The incidence of biphasic reactions was 7.1% (17/239) of cases. Common triggers of biphasic responses were foods (57.7%), drugs (31%), other known allergens (5.9%). Shellfish, edible insects, and wheat were the leading food triggers. Biphasic responses were significantly associated with history of drug allergy, any allergic disease, allergic rhinitis, number of prior anaphylactic reactions, angioedema, less generalized erythema, less reaction to shellfish, reaction to NSAIDs, and no epinephrine giving at ED visit (all p < 0.1). From a 3-predictor prognostic model including drug/idiopathic reaction, duration from onset to first epinephrine > 60 minutes, and any cutaneous edema/angioedema with an area under the curve of 0.72 (95%CI 0.54, 0.90). The incidence of biphasic response was 7.1%. Predictors of biphasic response were drug/idiopathic reac- tion, any cutaneous edema/angioedema, and time from onset to first epinephrine > 60 minutes.

New SARS-CoV-2 Omicron subvariant. Is XBB.1.5 associated with an increase in COVID-19 morbidity?

As a result of genetic changes and mutations of SARS-CoV-2, new variants emerge that have different properties compared to the original strains of the virus, which is a challenge for public health. XBB.1.5, also known as Kraken, is a subvariant of Omicron, and it is the most infectious and transmissible strain of SARS-CoV-2 to date. XBB.1.5 is the dominant strain in the United States of America, spreading worldwide, including in Europe and Asia. XBB.1.5 has properties to evade the immune system and reinfect individuals who have had COVID-19 before due to its strong binding to angiotensin-converting enzyme 2, and antibody evasion. Treatment and postexposure prophylaxis using monoclonal antibodies are ineffective against the Kraken variant, which is especially problematic for immunocompromised individuals and those with contraindications for vaccination, for example due to severe anaphylaxis or anaphylactic shock after prior administration of the vaccine, who require additional preventive measures. However, antiviral drugs including remdesivir, molnupiravir, nirmatrelvir, and ensitrelvir are still effective in treating COVID-19 caused by the XBB.5 variant. Currently, vaccine efficacy against XBB.1.5 variant is yet unknown. However, according to early studies, XBB and its sublineages have a greater ability for immune evasion than other variants, and the protection against infection via vaccination is reduced.

Safety of BNT162b2 mRNA COVID-19 vaccine in children with chronic kidney disease: a national population study from South Korea.

In South Korea, COVID-19 vaccination has been recommended to adolescents aged 12 - 17 since October, 2021. We aimed to assess the rate of adverse events following COVID-19 vaccination in adolescents with chronic kidney disease (CKD) in South Korea, using national cohort data. We retrieved the clinical information of adolescents 12 - 17years old from the Korea Disease Control and Prevention Agency-COVID19-National Health Insurance Service (K-COV-N) database, to calculate incidence rates of purpura and other hemorrhagic conditions, Guillain-Barré syndrome (GBS), Kawasaki disease/multisystem inflammatory syndrome in children (MIS-C), myocarditis and/or pericarditis, and anaphylaxis in adolescents with CKD, after BNT162b2 vaccination. Among the 2306 adolescents with CKD, 62.7% (n = 1446) had received the BNT-162b2 vaccine. GBS, Kawasaki disease/MIS-C, and anaphylaxis or anaphylactic shock did not occur during the observation period. Purpura and hemorrhagic conditions were more frequent in the unvaccinated group (7/860 vs. 1/1446), while myocarditis/pericarditis was observed only in the vaccinated group (0/860 vs. 1/1446). Adjusted odds ratio for any of the two adverse events was lower in vaccinated adolescents than in the unvaccinated group which did not reach statistical significance (adjusted odds ratio = 0.14, 95% confidence interval: 0.02, 1.16, P = 0.068). In this national cohort study of adolescents with CKD in South Korea, we observed no evidence of increased risk of adverse events following BNT162b2 vaccination. Our finding offers insights into the safety of COVID-19 vaccines, empowering adolescent patients with CKD and their caregivers to make informed decisions.

Alpha-gal Syndrome - A Case Report of Tick-Borne Anaphylactic Shock.

Alpha-gal syndrome, otherwise known as "red meat allergy", is a potentially life-threatening allergic syndrome induced by the immunological properties of tick saliva.A typical case of alpha-gal syndrome is a patient bitten by a tick who develops an allergic reaction, anaphylaxis or anaphylactic shock even after an ingestion of a significant amount of alpha-gal, typically present in red mammalian meat or organs.As global warming continues, we may expect tick-borne diseases to spread wider around the globe and due to the possibility of complete absence of typical allergic symptomatology and the delayed onset of symptoms, this syndrome needs to be considered when encountering vasoplegic shock of uncertain origin.

Heparin-induced Anaphylaxis shock.

Introduction: Anaphylaxis is a fatal condition that can be easily managed if discovered early. Only a few examples of anaphylaxis-like reactions caused by heparin have been documented, and immediate-type hypersensitivity reactions to heparin are extremely uncommon. Case Presentation: We report a case of a 53-yearold gentleman known to have an End Stage Renal Disease (ESRD) on Hemodialysis for two years, who went to the dialysis facility in his usual state of health. After two hours of dialysis, a new lock of taurolidine/heparin was installed; one minute later, the patient started to vomit and became restless, blood pressure dropped to 60/47 mmHg, and urticarial hives and a reddish rash developed on his skin, covering his trunk and limbs. He was immediately given three doses of epinephrine intramuscularly, which he did not respond to. Therefore, an epinephrine infusion was started. IV hydrocortisone and diphenhydramine were given for symptomatic relief. The patient was shifted to the emergency department, where he became vitally stable and returned to baseline. Heparininduced anaphylaxis was assumed based on the quick response to the above medications. Conclusion: This case can be added to the growing literature regarding this rare reaction, and more studies should be done to understand the nature of the reaction better. We recommend that the healthcare team becomes vigilant of heparin as a possible cause of anaphylaxis.

Cardioprotection by methylene Blue Against Epinephrine-Induced Cardiac Arrhythmias and Myocardial Injury

Methylene blue is used in the treatment of vasoplegic syndrome after cardiac surgery, anaphylaxis, and septic shock refractory to epinephrine and fluid resuscitation. In this study, we investigated the potential protective effect of methylene blue on the development of cardiac arrhythmias after injection of epinephrine in rats. Methylene blue was given intraperitoneally at doses of 50 or 100 mg/kg. Cardiac arrhythmia was then induced with 10 μg/kg of epinephrine intravenously. In untreated, control rats, epinephrine caused bradycardia (96.48 ± 1.06 vs. 365.03 ± 0.68 beats/min), increased PR interval (0.54 ± 0.04 vs. 0.039 ± 0.004), RR interval (0.64 ± 0.003 vs. 0.16 ± 0.004 sec), shortened QTc interval (0.067 ± 0.05 vs. 0.1 ± 0.004 sec), increased QRS duration (0.048 ± 0.005 vs. 0.028 ± 0.002 sec), decreased R wave amplitude (0.3 ± 0.03 vs. 0.49 ± 0.04 mv), decreased the height of the ST segment (-0.0696 ± 0.004 vs. -0.0054 ± 0.003 mv), and caused ventricular extrasystoles (7.92 ± 0.56 vs. 0.5 ± 0.5). Methylene blue given at 50 or 100 mg/kg increased the heart rate, decreased RR interval, QRS duration and the drop in the ST height, increased duration of QTc interval and R wave amplitude and decreased the number of extrasystoles. The histological study showed that methylene blue protected against myocardial structural disorganization, cellular damage, necrosis, and haemorrhage between muscle fibres induced by epinephrine injection. We conclude that methylene blue dose-dependently prevented epinephrine-induced arrhythmias and cardiac muscle injury.

Analisis Tartazin pada Makanan dan Minuman

&#x0D; &#x0D; &#x0D; &#x0D; Additives that are often used in food and beverages with the aim of attracting the attention of consumers, namely commonly known as addictive substances in food and beverages, can be in the form of dyes, flavoring and aroma, enhancers, antioxidants, preservatives, emulsifiers, bleaches, thickeners and sweeteners. Tartrazine or FC&amp;C Yellow 5 dye code E 102 is a synthetic dye that produces a lemon yellow color which is easily soluble in water, and is a derivative of coal tar which is a mixture of phenolic compounds, polycyclic and heterocyclic hydrocarbons. The tartrazine compound is resistant to light, acetic acid, HCl and 10% NaOH, while 30% NaOH will undergo a chemical reaction with a reddish color change. Easily faded in the presence of an oxidizing agent, FeSO4 will make the substance solution cloudy, whereas in the presence of copper (Cu) there will be a change from yellow to reddish. paper chromatography and Uv-Vis spectrophotometry methods were positive for containing Tartrazine dye with levels that exceeded the limit set by ADI (Acceptable Daily Intake), which is around 7.5 mg/Kg/day. Tartrazine dye levels in samples A, B, C, D and E respectively 1.06457 ; 28.1832 ; 40.6126 ; 15.7269 and 28.936 mg/L. The use of tartrazine that exceeds the maximum limit permitted by the Government can cause harmful effects to the health of the body. Among them such as causing urticaria (skin allergies), rhinitis (runny nose), asthma, purpura (bruises on the skin) and systemic anaphylaxis (shock). The maximum limit for the use of tartrazine coloring permitted by the Government of Indonesia based on BPOM Regulation Number 11 of 2019 states that the maximum level of use of tartrazine in food additives is a maximum of 100 mg/kg for confectionery or candy which includes hard and soft confectionery, nougat and others.&#x0D; &#x0D; &#x0D; &#x0D;

Anaphylaxis should be recognized early and managed appropriately

Anaphylaxis is a severe, systemic hypersensitivity reaction characterized by rapid in onset with potentially life-threatening. The prevalence of anaphylaxis has been estimated at 1.6% to 5.1% and increasing nowadays. Drug-Induce-Anaphylaxis is one the most cause of fatal anaphylaxis. A 26-year-old male with anaphylaxis shock due to drug-induced with total IgE as a diagnostic support test. Anaphylaxis is a multisystem allergic emergency. Early recognition and prompt administration of epinephrine remain the cornerstone of management due to its rapid progression.

History-based preoperative evaluation of antibiotic-related allergies and design of an easy to use questionnaire.

An unconfirmed history of antibiotic allergies may negatively influence prescribing patterns for preoperative antibiotic prophylaxis and increase rates of postoperative wound infections through unnecessary use of alternative antibiotics. After a literature search, we developed aquestionnaire for the structured collection of antibiotic allergy history in the anesthesia consultation center and tested it over 2 years at atertiary care hospital under everyday conditions as part of aquality assurance project. All data were evaluated completely anonymously in the context of standard care. After refining the questionnaire, we analyzed 4866 recorded optimized questionnaires, of which51 were incomplete. An antibiotic allergy was denied 4312times and affirmed 503times, which corresponds to 10% in our sample. The most frequent single substances or groups in the 503 respondents with apositive history of antibiotic allergy were penicillin in 271 (54%), amoxicillin in65 (13%), an unknown single agent in50 (10%) and multiple substances in25 (5%). The reported event occurred more than 10years ago in 192 (38%) of the respondents, less than 10years ago in 116 (23%), and 195 (39%) could not provide information. The time from exposure to symptom onset was less than 1h in96 (19%), between 1 and 24 h in75 (15%), more than 24 h in 106 (21%), and the remainder could not provide information. Allergy-specific treatment was recalled by75 (15%) respondents, 287 (57%) reported not having received specific treatment, and the remainder could not recall. Aspecific allergy test was reported by55 (11%) respondents, 337 (67%) said no allergy test had been made, and the rest could not recall. Asubstance-specific allergy passport was issued in80 (16%) respondents. According to expert assessment, symptoms compatible with an IgE-mediated reaction were present in96 (19%) of the respondents. An IgE-mediated reaction was considered possible in70 (14%) and could be excluded by history in 337 (67%) of respondents. Out of 503 respondents with apositive history 51(10%) could not remember the allergic substance but7 (14%) of the 51reported symptoms compatible with severe anaphylaxis or anaphylactic shock and6 of the51(12%) reported symptoms possibly related to an IgE-mediated reaction. Our survey revealed approximately 10% of respondents reporting an antibiotic allergy, which is in the upper range of data published in international literature and corresponds most closely to American data. Thus, the topic is also relevant to German anesthesia consultation centers, given the high rate of respondents who could have been "delabeled" based on the comprehensive assessment of their history. More expert allergy testing is needed in patients who report symptoms related or probably related to an IgE-mediated reaction. In our opinion, aspecial issue exists in those patients who did not remember the exact antibiotic but reported symptoms compatible with severe anaphylaxis putting them at high risk of unintended re-exposure.

A Case Report of Anaphylactic Shock Due to Hornet Sting with Multiple Organ Dysfunction Complications

BACKGROUND: Hornet venom has been recognized to induce lethal systemic effects such as anaphylaxis shock, bronchospasm, acute kidney or liver injury, disseminated intravascular coagulation (DIC), cardiovascular collapse, and even death. It consists of several enzymes and polypeptides with low molecular weights. It has been reported to contain the enzymes phospholipase A2, hyaluronidase, phosphomonoesterase acid ester, α-D-glucosidase, lysophospholipase, α-galactosidase, α-acetylamino-deoxsiglucosidase, and arylamidase. The venom will cause localized or systemic inflammation, an anticoagulant effect that may be fatal. CASE REPORT: Herewith, a survival case report suffered from DIC with multi-organ failure following severe anaphylaxis shock post a hundred or massive Hornet sting. CONCLUSION: We have reported a case of anaphylactic shock after a massive hornet sting with DIC that presented symptoms of shock, AKI, ALI, and multi-site bleeding. Although the mortality rate for similar cases is quite high, the outcome will be better with comprehensive and adequate treatment.

English

The prevalence of anaphylactic shock, the most severe manifestation of anaphylaxis, remains unknown. Risk factors and biomarkers have not been fully identified. Objective: To identify risk factors in patients who experience anaphylactic shock. Using lipid transfer protein (LTP) allergy as a model, we compared the characteristics of patients who developed anaphylaxis and anaphylactic shock. We recorded demographics, pollen sensitization, foods ingested up to 2 hours before onset of the reaction, and the presence of cofactors. Culprit foods were identified through a compatible clinical history and positive allergology work-up (skin prick test and/or sIgE). We evaluated 150 reactions in 55 patients with anaphylaxis (134 reactions) and 12 with anaphylactic shock (16 reactions). Patients in the anaphylaxis group experienced twice as many reactions (mean [SD], 2.4 [2.5] for anaphylaxis vs 1.3 [1.5] for anaphylactic shock; P<.02). No relationship was found between any food group and severity of the reaction. The most frequent food involved in both groups of patients was the combination of several plant-derived foods (plant food mix), followed by peach and nuts. Indeed, in the reactions caused by plant food mix, the presence of a cofactor was observed more often than in other food groups. On the other hand, cofactors were not present in peach- and nut-related reactions. Exercise was the most frequent cofactor in all groups. In our series, the severity of the reactions was not determined by the kind of food or presence of a cofactor. Anaphylactic shock seems to be an infrequent presentation that may be associated with other individual-related factors requiring further evaluation.

Prize‐winning abstracts from BSACI/WAO 2022 meeting

Prize‐winning abstracts from <scp>BSACI</scp>/<scp>WAO</scp> 2022 meeting

A reminder of life-threatening reaction of hymenoptera sting cause anaphylaxis shock

The prevalence of hymenoptera sting in general population still high. Large local reaction (LLR) is more common manifestation but can also cause anaphylactic shock and loss of consciousness, or even cardiac or respiratory arrest that all is defined as severe systemic sting reaction (SSR). The risk is generally considered low for future SSR in subjects with LLR but need to be considered and recognized immediately. We reported a case of 39-year-old women was stung by a wasp when driving motorcycle and presented to emergency room with anaphylactic shock (fulfill the amended NIAID/FAAN criteria). She also stung by wasp 2 years ago and cause her left upper and lower arms became swollen slowly and improved 3 days later after treatment with allergy drugs. Electrocardiography result refer to sinus bradycardia. Significant laboratory result showed hypokalemia (2.9 mmol/l). Patient treated by injecting epinephrine intramuscularly and glucocorticoids to preventing protracted symptoms and biphasic reactions.

Anaphylactic shock in children and adolescents

Modern views about the various causes of the development of anaphylactic shock in children and adolescents, the classification of anaphylactic shock based on the pathophysiological mechanisms of the development are observed in the survey. The algorithm of the diagnosis of anaphylaxis and anaphylactic shock, the emergency assistance and further management of patients with anaphylactic shock, as well as the issues of its prevention are presented.

Anaphylactic shock after Ranitidine – a Case report

Purpose: Anaphylactic shock is a severe, unexpected, life-threatening generalized hypersensitivity reaction that is usually triggered by antigens such as food, venom or drugs. Among drugs, ranitidine is considered safe and is even used in allergic reactions to decrease skin rash. However, in rare cases, ranitidine can provoke anaphylaxis or even anaphylactic shock.&#x0D; Case report: We present the case of a 30-year-old woman with abdominal pain, treated with i.v. bolus of ranitidine after previous occasional oral ranitidine ingestion. Within minutes, she developed symptoms and signs of anaphylactic shock. Immediate treatment was initiated with i.v. adrenaline, fluid infusion, and i.v. hydrocortisone and clemastine. After admission to the intensive care unit, treatment was continued, includingi.v. vasopressors. Intubation and mechanical ventilation were needed because of acute respiratory failure. After 2 days, the situation resolved completely. After she was extubated, the patient could breathe spontaneously without the need for additional oxygen. She was discharged without any sequelae within a few days.&#x0D; Conclusion: We conclude that even ranitidine, which has been used safely for many years, can trigger anaphylaxis and/or anaphylactic shock. In cases of anaphylactic shock, treatment with vasopressors, intubation and mechanical ventilation is needed to preserve life.

Severe Anaphylaxis in Pregnancy: A Systematic Review of Clinical Presentation to Determine Outcomes.

Anaphylactic reactions during pregnancy can range from subjective cutaneous symptoms to anaphylaxis and lethal anaphylactic shock. The fetal and maternal outcomes are unpredictable. This study is the first systematic review of the clinical presentation of severe anaphylaxis in pregnancy as defined by the World Allergy Organization to determine maternal and fetal outcomes. We searched PubMed, the Web of Science, and Scopus databases for articles published between 1 January 1985 and 15 April 2021 using the following terms (((anaphylactic shock) AND (pregnancy)) OR ((anaphylaxis) AND (pregnancy))). In 42 studies involving 47 patients, 36.17% of patients were 31–35 years old, and 74.47% of cases occurred peripartum, mostly during cesarean section. Accurate diagnosis with valid and reliable outcome measures was reported for 71.74% of cases. Twenty-two allergens were identified: antibiotics (penicillins and cephalosporins), anesthetic drugs (suxamethonium, mepivacaine), latex, oxytocin, sodium and sucrose iron, laminaria, misoprostol, rubber from Foley catheter, oral phytomenadione, ranitidine, chamomile, and ant sting. Two cases of maternal death related to latex and intravenous iron sucrose, and six infants with neurological disease were reported, mostly related to antibiotics. This review of the currently available literature shows that favorable outcomes are attainable with a high degree of observation, multidisciplinary cooperation, and rapid treatment.

Basophil Activation Marker Selection, CD63 or CD203c, Improves Sensitivity of Basophil Activation Test Depending on the Clinical Entity in Immediate Allergic Reactions to Betalactams

Basophil activation test (BAT) is a reliable in vitro tool to evaluate immediate allergic reactions to betalactams (BL). The optimal activation marker for BAT analysis could depend on the mechanism involved. The aim of the study was to evaluate the role of CD63 and CD203c in basophil activation from amoxicillin (AX) and clavulanic acid (CLV) allergic patients with different clinical entities: urticaria (URT), anaphylaxis (ANA) and anaphylactic shock (AS).

Mining of mortality-related findings in rare bleeding disorders: a retrospective study from two centers.

BackgroundRare bleeding disorders include inherited coagulation disorders except for von Willebrand disease and hemophilia A and B. These disorders affect both men and women worldwide and mainly have an autosomal recessive pattern of inheritance. Given the paucity of cases of rare bleeding disorders, there are limited data regarding some topics among bleeding disorders.MethodsThis retrospective study from 2005‒2019 collected demographic data and the causes of death among cases with rare bleeding disorders from 2 provinces of Iran.ResultsOverall, 5 deaths were reported, including 3 cases with factor V deficiency, a case with factor XIII deficiency, and a case with combined factor V and factor VIII deficiencies. The main causes of death were bleeding in the central nervous system (2 cases; 1 with factor V deficiency and 1 with combined factor XIII deficiency). Post-partum hemorrhage was the cause of death in a woman with factor V deficiency while anaphylaxis shock was the cause of death in the case with combined factor V and factor VIII deficiencies. A woman with factor V deficiency died from an internal bleeding episode.ConclusionGathering data on the causes of death in rare bleeding disorders through worldwide registries can be helpful for the management of this rare group of bleeding disorders.

Assessing of patients’ knowledge of anaphylactic shock and allergies.

Background: The World Health Organization (WHO) identified allergy as one of the major problems of the 21st century. It was also stated to be a key issue for health protection and public health care activity in the White Book on Allergy published in 2011. An allergy or atopy is called type I hypersensitivity. It may take the form of immediate (anaphylaxis) or late symptoms including allergic rhinitis and eye diseases, atopic dermatitis, food allergies, anaphylactic shock, allergic asthma and hives. Anaphylaxis and anaphylactic shock can occur at any age. Aim of the study: The goal of the study was to assess patient knowledge about allergies and appropriate actions to take in situations of severe allergic symptoms including anaphylactic shock. Material and methods: The study was conducted in 2018 among 150 adult patients in a clinic of Allergy at Optima Medycyna SA in Opole. The author’s survey questionnaire contained 27 closed single or multiple-choice questions. Results: A satisfactory level of knowledge of the most life-threatening allergy exacerbations was found in 79.3% (119) of the examinees. 53.3% (80) had correct knowledge of how to act in the case of a severe allergic shortness of breath and symptoms that do not subside despite administering medications. In such instances, 46.7% did not know what to do. Only 84.7% (127) of respondents knew the definition of anaphylactic shock while 10% (15) did not know the concept at all. Conclusions: Patients showed a significantly higher level of knowledge about allergy complications than about their causes and prevention. Knowledge about the diagnosis of allergy exacerbations, as well as steps to take in life-threatening situations associated with acute allergic disease and anaphylactic shock in home situations was insufficient. In addition, it was found that nursing staff insufficiently educate patients on allergies and associated complications.