Ehrhard Simone, Eyb Vicky, Gautschi Dominic, Schauber Stefan K, Ricklin Meret E, Klukowska-Rötzler Jolanta, Exadaktylos Aristomenis K, Helbling Arthur
Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 16C, 3010, Bern, Switzerland.
Centre for Health Science Education, Faculty of Medicine, University of Oslo, Oslo, Norway.
Allergy Asthma Clin Immunol. 2024 May 31;20(1):35. doi: 10.1186/s13223-024-00901-y.
Anaphylaxis is the most severe form of acute systemic and potentially life-threatening reactions triggered by mast and basophilic cells. Recent studies show a worldwide incidence between 50 and 112 occurrences per 100,000 person-years. The most identified triggers are food, medications, and insect venoms. We aimed to analyze triggers and clinical symptoms of patients presenting to a Swiss university emergency department for adults.
Six-year retrospective analysis (01/2013 to 12/2018) of all patients (> 16 years of age) admitted with moderate or severe anaphylaxis (classification of Ring and Messmer ≥ 2) to the emergency department. Patient and clinical data were extracted from the electronic medical database of the emergency department.
Of the 531 includes patients, 53.3% were female, the median age was 38 [IQR 26-51] years. The most common suspected triggers were medications (31.8%), food (25.6%), and insect stings (17.1%). Organ manifestations varied among the different suspected triggers: for medications, 90.5% of the patients had skin symptoms, followed by respiratory (62.7%), cardiovascular (44.4%) and gastrointestinal symptoms (33.7%); for food, gastrointestinal symptoms (39.7%) were more frequent than cardiovascular symptoms (36.8%) and for insect stings cardiovascular symptoms were apparent in 63.8% of the cases.
Average annual incidence of moderate to severe anaphylaxis during the 6-year period in subjects > 16 years of age was 10.67 per 100,000 inhabitants. Medications (antibiotics, NSAID and radiocontrast agents) were the most frequently suspected triggers. Anaphylaxis due to insect stings was more frequently than in other studies. Regarding clinical symptoms, gastrointestinal symptoms need to be better considered, especially that initial treatment with epinephrine is not delayed.
过敏反应是由肥大细胞和嗜碱性粒细胞引发的最严重的急性全身性且可能危及生命的反应。近期研究表明，全球范围内每10万人年的发病率在50至112例之间。最常见的诱发因素是食物、药物和昆虫毒液。我们旨在分析瑞士一所大学成人急诊科患者的诱发因素和临床症状。
对急诊科收治的所有中度或重度过敏反应（Ring和Messmer分类≥2）患者（年龄>16岁）进行为期六年的回顾性分析（2013年1月至2018年12月）。患者和临床数据从急诊科的电子医疗数据库中提取。
在纳入的531例患者中，53.3%为女性，中位年龄为38岁[四分位间距26 - 51岁]。最常见的可疑诱发因素是药物（31.8%）、食物（25.6%）和昆虫叮咬（17.1%）。不同可疑诱发因素的器官表现各异：对于药物，90.5%的患者有皮肤症状，其次是呼吸道症状（62.7%）、心血管症状（44.4%）和胃肠道症状（33.7%）；对于食物，胃肠道症状（39.7%）比心血管症状（36.8%）更常见，而对于昆虫叮咬，63.8%的病例出现心血管症状。
在6年期间，年龄>16岁的受试者中，中度至重度过敏反应的年均发病率为每10万居民10.67例。药物（抗生素,非甾体抗炎药和造影剂）是最常被怀疑的诱发因素。昆虫叮咬引起的过敏反应比其他研究中更为频繁。关于临床症状，需要更好地考虑胃肠道症状，尤其是在不延迟肾上腺素初始治疗的情况下。
