Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Allergy Unit, Department of Dermatology, University Hospital Basel, Basel, Switzerland.
Allergy. 2023 Jun;78(6):1615-1627. doi: 10.1111/all.15612. Epub 2022 Dec 20.
Drugs are a frequent cause of severe anaphylactic reactions. Here, we analyze a large dataset on drug induced anaphylaxis regarding elicitors, risk factors, symptoms, and treatment.
Data from the European Anaphylaxis Registry (2007-2019) with 1815 reported cases of drug-induced anaphylaxis were studied accordingly.
Drugs are the third most frequent cause of anaphylaxis reported in the Anaphylaxis Registry. Among the eliciting groups of drugs analgesics and antibiotics were far most often reported. Female and senior patients were more frequently affected, while the number of children with DIA was low. DIA patients had symptoms affecting the skin and mucous membranes (n = 1525, 84.02%), the respiratory (n = 1300, 71.63%), the cardiovascular (n = 1251, 68.93%) and the gastrointestinal system (n = 549, 30.25%). Drugs caused significant more severe reactions, occurred more often in medical facilities and led to increased hospitalization rates in comparison to food and insect venom induced anaphylaxis. Adrenaline was used more often in patients with DIA than in anaphylaxis due to other causes. Patients with skin symptoms received more antihistamines and corticosteroids in the acute treatment, while gastrointestinal symptoms led to less adrenaline use.
The study contributes to a better understanding of DIA, with a large number of cases from Europe supporting previous data, e.g., analgesics and antibiotics being the most frequent culprits for DIA. Female gender and higher age are relevant risk factors and despite clear recommendations, the emergency treatment of DIA is not administered according to the guidelines.
药物是引发严重过敏反应的常见原因。在此，我们分析了关于药物诱发过敏反应的诱发因素、危险因素、症状和治疗的大型数据集。
对欧洲过敏反应登记处（2007-2019 年）的 1815 例药物诱发过敏反应报告病例进行了研究。
药物是过敏反应登记处报告的第三大常见过敏原因。在诱发药物组中，镇痛药和抗生素报告最多。女性和老年患者更容易受到影响，而儿童 DIA 患者的数量较少。DIA 患者的症状影响皮肤和黏膜（n=1525，84.02%）、呼吸系统（n=1300，71.63%）、心血管系统（n=1251，68.93%）和胃肠道系统（n=549，30.25%）。与食物和昆虫毒液引起的过敏反应相比，药物引起的过敏反应更严重，更常发生在医疗场所，导致住院率增加。与其他原因引起的过敏反应相比，DIA 患者更常使用肾上腺素。在急性治疗中，有皮肤症状的患者接受了更多的抗组胺药和皮质类固醇，而胃肠道症状导致较少使用肾上腺素。
该研究有助于更好地了解 DIA，来自欧洲的大量病例支持了先前的数据，例如，镇痛药和抗生素是 DIA 最常见的罪魁祸首。女性和年龄较大是相关危险因素，尽管有明确的建议，但 DIA 的紧急治疗并未按照指南进行。
