Kim Sang-Yoon, Kim Min-Hye, Cho Young-Joo
Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea.
Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea.
Allergol Int. 2018 Jan;67(1):96-102. doi: 10.1016/j.alit.2017.05.005. Epub 2017 Jun 8.
Anaphylaxis is a life-threatening allergic reaction. Several studies reported different anaphylactic reactions according to the causative substances. However, a comparison of anaphylaxis for each cause has not been done. This study was conducted to identify common causes of anaphylaxis, characteristics of anaphylactic reaction for each cause and to analyze the factors related to the severity of the reaction.
Medical records of patients who visited the emergency room of Ewha Womans University Mokdong Hospital from March 2003 to April 2016 and diagnosed with anaphylactic shock were retrospectively reviewed. We compared the clinical features of anaphylaxis according to the cause. In addition, the severity of anaphylaxis was analyzed and contributing factors for severe anaphylaxis were reviewed.
A total of 199 patients with anaphylaxis were analyzed. Food was the most common cause (49.7%), followed by drug reaction (36.2%), bee venom (10.1%), and unknown cause (4.0%). Cardiovascular symptoms of syncope and hypotension were more common in drug-induced anaphylaxis. The incidence of severe anaphylaxis was the highest in anaphylaxis due to drugs (54.2%). Urticaria and other skin symptoms were significantly more common in food-induced anaphylaxis. Risk factors for severe anaphylaxis included older age, male, and drug-induced one. Epinephrine treatment of anaphylaxis was done for 69.7% and 56.9% of patients with food-induced and drug-induced anaphylaxis, respectively.
More severe anaphylaxis developed with drug treatment and in males. Low rate of epinephrine prescription was also observed. Male patients with drug induced anaphylaxis should be paid more attention.
过敏反应是一种危及生命的过敏反应。多项研究报告了根据致病物质不同而出现的不同过敏反应。然而，尚未对每种病因导致的过敏反应进行比较。本研究旨在确定过敏反应的常见病因、每种病因所致过敏反应的特征，并分析与反应严重程度相关的因素。
回顾性分析2003年3月至2016年4月在梨花女子大学木洞医院急诊室就诊并诊断为过敏性休克的患者的病历。我们根据病因比较了过敏反应的临床特征。此外，分析了过敏反应的严重程度，并回顾了严重过敏反应的促成因素。
共分析了199例过敏反应患者。食物是最常见的病因（49.7%），其次是药物反应（36.2%）、蜂毒（10.1%）和不明病因（4.0%）。晕厥和低血压等心血管症状在药物性过敏反应中更为常见。药物所致过敏反应中严重过敏反应的发生率最高（54.2%）。荨麻疹和其他皮肤症状在食物性过敏反应中明显更为常见。严重过敏反应的危险因素包括年龄较大、男性以及药物性过敏反应。分别有69.7%和56.9%的食物性和药物性过敏反应患者接受了肾上腺素治疗。
药物治疗及男性患者发生的过敏反应更为严重。肾上腺素处方率也较低。药物性过敏反应的男性患者应得到更多关注。
