Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry

Francuzik, Wojciech; Rueeff, Franziska; Bauer, Andrea; Bilo, Maria Beatrice; Cardona, Victoria; Christoff, George; Doelle-Bierke, Sabine; Ensina, Luis; Rivas, Montserrat Fernandez; Hawranek, Thomas; Hourihane, Jonathan O'b; Jakob, Thilo; Papadopoulos, Nicos G.; Pfoehler, Claudia; Poziomkowska-Gesicka, Iwona; Brempt, Xavier van der; Hofmeier, Kathrin Scherer; Treudler, Regina; Wagner, Nicola; Wedi, Bettina und Worm, Margitta (2021): Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry. In: Journal of Allergy and Clinical Immunology, Bd. 147, Nr. 2: S. 653-662

Abstract

Background: Venom-induced anaphylaxis (VIA) is a common, potentially life-threatening hypersensitivity reaction associated with (1) a specific symptom profile, 2) specific cofactors, and 3) specific management. Identifying the differences in phenotypes of anaphylaxis is crucial for future management guidelines and development of a personalized medicine approach. Objective: This study aimed to evaluate the phenotype and risk factors of VIA. Methods: Using data from the European Anaphylaxis Registry (12,874 cases), we identified 3,612 patients with VIA and analyzed their cases in comparison with sex- and age-matched anaphylaxis cases triggered by other elicitors (non-VIA cases [n = 3,605]). Results: VIA more frequently involved more than 3 organ systems and was associated with cardiovascular symptoms. The absence of skin symptoms during anaphylaxis was correlated with baseline serum tryptase level and was associated with an increased risk of a severe reaction. Intramuscular or intravenous epinephrine was administered significantly less often in VIA, in particular, in patients without a history of anaphylaxis. A baseline serum tryptase level within the upper normal range (8-11.5 ng/mL) was more frequently associated with severe anaphylaxis. Conclusion: Using a large cohort of VIA cases, we have validated that patients with intermediate baseline serum tryptase levels (8-11 ng/mL) and without skin involvement have a higher risk of severe VIA. Patients receiving beta-blockers or angiotensin-converting enzyme inhibitors had a higher risk of developing severe cardiovascular symptoms (including cardiac arrest) in VIA and non-VIA cases. Patients experiencing VIA received epinephrine less frequently than did cases with non-VIA.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0091-6749
• Sprache: Englisch