Department of Dermatology and Allergy, University Hospital Charité, Berlin, Germany.
Allergy. 2012 May;67(5):691-8. doi: 10.1111/j.1398-9995.2012.02795.x. Epub 2012 Feb 16.
Anaphylaxis is the most severe manifestation of an IgE-dependent allergy. Standardized acquired clinical data from large cohorts of well-defined cases are not available. The aim of this study was to analyse the symptom profile and risk factors of anaphylaxis in a large Central European cohort.
We acquired data from patients in Germany, Austria and Switzerland who experienced a severe allergic reaction defined by the onset of severe pulmonary and/or severe cardiovascular symptoms. The data were gained via an online questionnaire from 83 medical centres specialized in allergy. Data were collected from 2006 to 2010 and analysed by using a multinomial regression model.
A total of 2012 paediatric and adult patients were included into the present analysis. The skin (84%) was the most frequently affected organ followed by the cardiovascular (72%) and the respiratory (68%) system. The regression model analysing the onset of cardiovascular versus respiratory symptoms revealed a strong impact of age (adjusted OR = 6.08; 95% CI, 3.35-11.01; P < 0.001). Furthermore, the elicitor food (adjusted OR = 0.29; 95% CI, 0.21-0.41, P < 0.001) and the presence of atopic diseases (adjusted OR = 0.54; 95% CI, 0.40-0.73, P < 0.001) were significantly associated with the onset of respiratory symptoms.
Data from individuals who experienced anaphylaxis can support the identification of risk factors. The present study indicates that age, the elicitor itself and the presence of atopic diseases have an impact on the symptom profile of anaphylaxis. Identifying further risk factors of anaphylaxis is of significant importance for clinical practice in the future.
过敏反应是 IgE 依赖性过敏的最严重表现形式。目前尚无来自大型明确病例队列的标准化获得性临床数据。本研究的目的是分析中欧大型队列中过敏反应的症状谱和危险因素。
我们从德国、奥地利和瑞士的 83 家过敏专科中心的患者中获取数据,这些患者出现严重过敏反应,表现为严重的肺部和/或严重的心血管症状。数据是通过在线问卷调查收集的,时间为 2006 年至 2010 年。使用多项回归模型进行数据分析。
共有 2012 名儿科和成年患者纳入本分析。皮肤(84%)是最常受累的器官,其次是心血管(72%)和呼吸系统(68%)。分析心血管症状与呼吸系统症状发病的回归模型显示,年龄的影响较大(调整后的 OR = 6.08;95%CI,3.35-11.01;P < 0.001)。此外,诱发物食物(调整后的 OR = 0.29;95%CI,0.21-0.41,P < 0.001)和特应性疾病的存在(调整后的 OR = 0.54;95%CI,0.40-0.73,P < 0.001)与呼吸系统症状的发病显著相关。
过敏反应患者的数据可以支持危险因素的识别。本研究表明,年龄、诱发物本身和特应性疾病的存在对过敏反应的症状谱有影响。确定过敏反应的其他危险因素对未来的临床实践具有重要意义。