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Risk Factors in Severe Anaphylaxis: Which Matters the Most, Food or Cofactors?
Casas-Saucedo, R; de la Cruz, C; Araujo-Sánchez, G; Gelis, S; Jimenez, T; Riggioni, S; San Bartolomé, C; Pascal, M; Bartra Tomás, J; Muñoz-Cano, R.
Affiliation
  • Casas-Saucedo, R; University of Barcelona. Hospital Clinic. Pneumology Department. Barcelona. Spain
  • de la Cruz, C; University of Barcelona. Hospital Clinic. Pneumology Department. Barcelona. Spain
  • Araujo-Sánchez, G; University of Barcelona. Hospital Clinic. Pneumology Department. Barcelona. Spain
  • Gelis, S; University of Barcelona. Hospital Clinic. Pneumology Department. Barcelona. Spain
  • Jimenez, T; IRCE – Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS). Barcelona. Spain
  • Riggioni, S; University of Barcelona. Hospital Clinic. Pneumology Department. Barcelona. Spain
  • San Bartolomé, C; IRCE – Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS). Barcelona. Spain
  • Pascal, M; IRCE – Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS. Barcelona. Spain
  • Bartra Tomás, J; University of Barcelona. Hospital Clinic. Pneumology Department. Barcelona. Spain
  • Muñoz-Cano, R; University of Barcelona. Hospital Clinic. Pneumology Department. Barcelona. Spain
J. investig. allergol. clin. immunol ; 32(4): 282-290, 2022. tab
Article in English | IBECS | ID: ibc-208240
Responsible library: ES1.1
Localization: ES15.1 - BNCS
ABSTRACT

Background:

The prevalence of anaphylactic shock, the most severe manifestation of anaphylaxis, remains unknown. Risk factors and biomarkers have not been fully identified.

Objective:

To identify risk factors in patients who experience anaphylactic shock.

Methods:

Using lipid transfer protein (LTP) allergy as a model, we compared the characteristics of patients who developed anaphylaxis and anaphylactic shock. We recorded demographics, pollen sensitization, foods ingested up to 2 hours before onset of the reaction, and the presence of cofactors. Culprit foods were identified through a compatible clinical history and positive allergology work-up (skin prick test and/or sIgE).

Results:

We evaluated 150 reactions in 55 patients with anaphylaxis (134 reactions) and 12 with anaphylactic shock (16 reactions). Patients in the anaphylaxis group experienced twice as many reactions (mean [SD], 2.4 [2.5] for anaphylaxis vs 1.3 [1.5] for anaphylactic shock; P<.02). No relationship was found between any food group and severity of the reaction. The most frequent food involved in both groups of patients was the combination of several plant-derived foods (plant food mix), followed by peach and nuts. Indeed, in the reactions caused by plant food mix, the presence of a cofactor was observed more often than in other food groups. On the other hand, cofactors were not present in peach- and nut-related reactions. Exercise was the most frequent cofactor in all groups.

Conclusion:

In our series, the severity of the reactions was not determined by the kind of food or presence of a cofactor. Anaphylactic shock seems to be an infrequent presentation that may be associated with other individual-related factors requiring further evaluation (AU)
RESUMEN
Antecedentes La prevalencia del shock anafiláctico sigue siendo desconocida. Aún no se han identificado completamente factores de riesgo ni biomarcadores.

Objetivo:

Identificar factores de riesgo de shock anafiláctico.

Método:

Utilizando la alergia a proteína de transferencia de lípidos (LTP) como modelo, se han comparado características de pacientes que han presentado una anafilaxia (An) y pacientes que han desarrollado un shock anafiláctico (SAn). Se recopilaron datos demográficos, sensibilización a pólenes, alimentos ingeridos hasta 2 horas antes del inicio de la reacción y la presencia o no de cofactores. El alimento implicado se identificó mediante historia clínica compatible y estudio alergológico positivo (prick test y/o IgE).

Resultados:

Se evaluaron un total de 150 reacciones; 55 pacientes del grupo An sufrieron 134 reacciones, y 12 pacientes del grupo SAn sufrieron 16 reacciones. El grupo An experimentó el doble de reacciones por paciente (media [DS] 2,4 [2,5] en An vs 1,3 [1,5] en SAn, p<0,02). No se observó relación entre el tipo de alimento y la gravedad de la reacción. El alimento implicado con más frecuencia en ambos grupos fue la combinación de varios vegetales (“mix de vegetales”), seguido por el melocotón y frutos secos. No hubo cofactores implicados en las reacciones con melocotón ni con frutos secos. En ambos grupos el eje rcicio fue el cofactor involucrado con más frecuencia.

Conclusión:

En nuestra serie, el alimento y la presencia de cofactor no determinan la gravedad de una reacción. Los shocks anafilácticos parecen ser una presentación infrecuente y podrían estar relacionados con factores individuales que precisarán una evaluación más extensa (AU)
Subject(s)


Full text: Available Collection: National databases / Spain Database: IBECS Main subject: Allergens / Prunus persica / Food Hypersensitivity / Anaphylaxis Limits: Adult / Female / Humans / Male Language: English Journal: J. investig. allergol. clin. immunol Year: 2022 Document type: Article Institution/Affiliation country: IRCE – Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS)/Spain / IRCE – Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS/Spain / University of Barcelona/Spain

Full text: Available Collection: National databases / Spain Database: IBECS Main subject: Allergens / Prunus persica / Food Hypersensitivity / Anaphylaxis Limits: Adult / Female / Humans / Male Language: English Journal: J. investig. allergol. clin. immunol Year: 2022 Document type: Article Institution/Affiliation country: IRCE – Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS)/Spain / IRCE – Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS/Spain / University of Barcelona/Spain
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