Brazil E, MacNamara A F
Accident and Emergency Department, County Hospital, Lincoln.
J Accid Emerg Med. 1998 Jul;15(4):252-3. doi: 10.1136/emj.15.4.252.
To assess how commonly clinically significant biphasic anaphylactic reactions occur after apparently successful treatment of an anaphylactic reaction. Cases were analysed to determine whether there were any markers that would allow early identification of patients who would subsequently develop a biphasic response.
Retrospective review of case notes of 34 patients admitted for observation after an anaphylactic reaction that had required treatment with adrenaline.
Six patients (18%) had biphasic reactions. No clinical features on initial presentation identified those likely to have a biphasic response. These patients however required significantly more adrenaline to ameliorate their initial symptoms (p = 0.03) compared with those having a simple uniphasic reaction.
Biphasic anaphylactic reactions occur frequently. There are no clinical features that allow identification of patients likely to have a biphasic response. These patients require higher doses of adrenaline to control their initial symptoms and this should be considered a marker for patients who may develop a biphasic response. These results confirm that all patients being discharged after treatment for an acute anaphylactic reaction must be made aware of the risk of a second phase response after apparent clinical resolution.
评估在过敏反应看似成功治疗后，具有临床意义的双相过敏反应的发生频率。对病例进行分析，以确定是否存在任何标志物，能够早期识别随后会出现双相反应的患者。
回顾性分析34例因过敏反应接受肾上腺素治疗后入院观察的患者的病历。
6例患者（18%）出现双相反应。初始表现时的临床特征无法识别可能出现双相反应的患者。然而，与单纯单相反应的患者相比，这些患者缓解初始症状所需的肾上腺素剂量显著更多（p = 0.03）。
双相过敏反应频繁发生。没有临床特征能够识别可能出现双相反应的患者。这些患者需要更高剂量的肾上腺素来控制初始症状，这应被视为可能出现双相反应患者的一个标志物。这些结果证实，所有因急性过敏反应接受治疗后出院的患者必须了解在临床症状明显缓解后出现第二阶段反应的风险。
