Journal ArticleDOI
Anaphylaxis during anesthesia in France: An 8-year national survey
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TLDR
The incidence of allergic reactions during anesthesia, estimated on a national basis, is higher than previously estimated and the similar incidence of reactions according to sex before adolescence suggests a role for sex hormones in the increase of anaphylaxis observed in women.Abstract:
Background More attention should be paid to rare serious adverse events such as anaphylaxis to increase the safety of anesthesia. Objective To report the results of an 8-year survey of anaphylaxis during anesthesia in France. Methods Data from patients who experienced anaphylaxis between January 1, 1997, and December 31, 2004, were analyzed. Estimated incidences were obtained by combining this database with data from the French pharmacovigilance system by using a capture-recapture method. The number of patients exposed to the offending agents was obtained from data collected during the national survey of anesthesia practice. Results A total of 2516 patients was included. A diagnosis of IgE-mediated reaction was established in 1816 cases (72.18%). The most common causes were neuromuscular blocking agents ([NMBAs]; n = 1067; 58.08%), latex (n = 361; 19.65%), and antibiotics (n = 236; 12.85%). The median annual incidence per million procedures was higher for females 154.9 (5th-95th percentile, 117.2-193.1) than for males 55.4 (5th-95th percentile, 42.0-68.0). It reached 250.9 (5th-95th percentile, 189.8-312.9) for women in cases of allergic reactions to NMBAs. In children, a diagnosis of IgE-mediated reactions was obtained in 122 cases (45.9%). The most common causes were latex (n = 51; 41.8%), NMBAs (n = 39; 31.97%), and antibiotics (n = 11; 9.02%). In contrast with adults, no female predominance was observed. Conclusion The incidence of allergic reactions during anesthesia, estimated on a national basis, is higher than previously estimated. These results should be taken into account in the evaluation of the benefit-to-risk ratio of the various anesthetic techniques in individuals. The similar incidence of reactions according to sex before adolescence suggests a role for sex hormones in the increase of anaphylaxis observed in women.read more
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Journal ArticleDOI
Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology
Antonella Muraro,Graham Roberts,Margitta Worm,M. B. Bilò,Knut Brockow,M. Fernandez Rivas,Alexandra F. Santos,Zaraquiza Zolkipli,Abdelouahab Bellou,Kirsten Beyer,Carsten Bindslev-Jensen,Victoria Cardona,Andrew Clark,Pascal Demoly,A. E. J. Dubois,Audrey DunnGalvin,Philippe Eigenmann,Susanne Halken,L. Harada,Gideon Lack,Gideon Lack,Marek Jutel,Bodo Niggemann,Franziska Ruëff,Frans Timmermans,Berber Vlieg-Boerstra,Thomas Werfel,S. Dhami,S. S. Panesar,Cezmi A. Akdis,Cezmi A. Akdis,Aziz Sheikh +31 more
TL;DR: These guidelines aim to provide evidence‐based recommendations for the recognition, risk factor assessment, and the management of patients who are at risk of, are experiencing, or have experienced anaphylaxis, and to prevent future episodes by developing personalized risk reduction strategies including, where possible, commencing allergen immunotherapy.
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Identification of a mast-cell-specific receptor crucial for pseudo-allergic drug reactions
Benjamin D. McNeil,Priyanka Pundir,Sonya Meeker,Liang Han,Bradley J. Undem,Marianna Kulka,Xinzhong Dong +6 more
TL;DR: In this paper, a mouse model was introduced to study mast cell activation by basic secretagogues and identify MRGPRX2 as a potential therapeutic target to reduce a subset of drug-induced adverse effects.
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Skin test concentrations for systemically administered drugs -- an ENDA/EAACI Drug Allergy Interest Group position paper
Knut Brockow,Lh Garvey,Werner Aberer,Marina Atanaskovic-Markovic,A. Barbaud,M. B. Bilò,Andreas J. Bircher,Miguel Blanca,B Bonadonna,Paolo Campi,E Castro,Jr Cernadas,Am Chiriac,Pascal Demoly,Martine Grosber,J Gooi,Carla Lombardo,Pm Mertes,Holger Mosbech,S Nasser,M. Pagani,J. Ring,Audrey Romano,Kathrin Scherer,B Schnyder,S. Testi,María José Torres,Axel Trautmann,Ingrid Terreehorst +28 more
TL;DR: This work has performed a literature search on skin test drug concentration in MEDLINE and EMBASE, reviewed and evaluated the literature in five languages using the GRADE system for quality of evidence and strength of recommendation, and recommends drug concentration for skin testing aiming to achieve a specificity of at least 95%.
Journal ArticleDOI
International consensus on (ICON) anaphylaxis
F. Estelle R. Simons,Ledit R.F. Ardusso,M. Beatrice Bilò,Victoria Cardona,Motohiro Ebisawa,Yehia El-Gamal,Phil Lieberman,Richard F. Lockey,Antonella Muraro,Graham Roberts,Mario Sánchez-Borges,Aziz Sheikh,Lynette Pei-Chi Shek,Dana Wallace,Margitta Worm +14 more
TL;DR: These guidelines concur about prompt initial treatment with intramuscular injection of epinephrine (adrenaline) in the mid-outer thigh, positioning the patient supine, calling for help, and when indicated, providing supplemental oxygen, intravenous fluid resuscitation and cardiopulmonary resuscitation.
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Masafumi Zaitsu,Shin Ichiro Narita,K. Chad Lambert,James J. Grady,D. Mark Estes,Edward M. Curran,Edward G. Brooks,Cheryl S. Watson,Randall M. Goldblum,Terumi Midoro-Horiuti +9 more
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Journal Article
Reducing the risk of anaphylaxis during anaesthesia: guidelines for clinical practice.
Paul-Michel Mertes,M C Laxenaire,A Lienhart,Werner Aberer,J. Ring,Werner J. Pichler,Pascal Demoly,Enda +7 more
TL;DR: These guidelines represent a consensus of experts in the field of immediate hypersensitivity reactions occurring during anaesthesia and are presented to provide the most valid, widely accepted, effective and easily teachable guidelines.
Journal ArticleDOI
Épidémiologie des réactions anaphylactiques et anaphylactoïdes peranesthésiques en France. Septième enquête multicentrique (Janvier 2001–Décembre 2002)
P.-M. Mertes,M.-C. Laxenaire +1 more
TL;DR: Les auteurs rapportent les donnees de the derniere enquete nationale effectuee par le GERAP (Groupe d’Etudes des Reactions Anaphylactoides Peranesthesiques) en 2001 et 2002, et comparent les resultats avec ceux des enquetes precedentes.
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