TORNA ALL’ELENCO

Drug-induced anaphylaxis: A 5 years review in an outpatient allergy clinic in Allergy: European Journal of Allergy and Clinical Immunology

2014
ASL Torino 3
AOU Città della Salute di Torino
AO Ordine Mauriziano

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (12)Vedi tutti...

Bommarito L

Mietta S

Marengo F


et alii...

Abstract

Background: Anaphylaxis is a potentially fatal systemic allergic reaction. Our objective was to characterise a case series of anaphylactic reactions due to drugs notified to Regional Observatory for severe allergic reactions of Piedmont Region during the past 5 years. Method: Cases of drug-induced anaphylaxis, notified by Allergy Outpatient Clinic of Città della Salute e della Scienza (Molinette Hospital, Turin, Italy), between 1 January 2009 and 31 December 2013 were reviewed. Demographical and clinical characteristics, causative drugs and approach leading to diagnosis were analyzed. Results: Eighty-four patients (55 women, 29 men) with at least one documented episode of drug-anaphylaxis were included, with a total number of 93 episodes described (seven patients reported two episodes and one patient three episodes). Mean age at the time episode was 40.4 years (SD ± 17.62 years); 54.9% of patients were atopics, 9% reporting also food allergy. Basal triptase levels (obtained in 41/84 patients) were higher than 11.4 lg/l in two patients. Causative drugs were antibiotics (64 betalactams and nine quinolones) in 79% of cases, nonsteroidal anti-inflammatory drugs in 17%, and other drugs (local anesthetic, radiocontrast media, vaccines) in 4% of cases. Amoxicillin-clavulanate was the most involved drug (33/93 of total episodes, 33/64 considering only betalactam antibiotics). Diagnosis was obtained in 18% of cases using serological tests only, in 51% performing also cutaneous tests, in 5% of cases also by an oral challenge. Conclusion: In our experience betalactam antibiotics, in particular amino-penicillins, are the most involved causative drug in anaphylaxis. The female gender was most represented and almost all episodes (83%) occurred between 14 and 65 years. Allergological work-up was helpful in final diagnosis in the majority of cases, probably due to the type of drugs involved.

DOI : 10.1111/all.12477

Keywords

serology; food allergy; allergic reaction; female; diagnosis; patient; anaphylaxis; clinical immunology; hospital; outpatient; human; allergy; penicillin derivative; quinolone derivative; nonsteroid antiinflammatory agent; amoxicillin; local anesthetic agent; contrast medium; vaccine; clavulanic acid; antibiotic agent; skin test; gender; male; Italy; outpatient department; case study;