Triggers and treatment of anaphylaxis: an analysis of 4,000 cases from Germany, Austria and Switzerland

Worm M, Eckermann O, Doelle S, Aberer W, Beyer K, Hawranek T, Hompes S, Koehli A, Mahler V, Nemat K, Niggemann B, Pfoehler C, Rabe U, Reissig A, Rietschel E, Scherer K, Treudler R, Rueff F (2014)

Publication Type: Journal article

Publication year: 2014

Journal

Deutsches Ärzteblatt international Deutscher Ärzte-Verlag

Book Volume: 111

Pages Range: 367-75

Journal Issue: 21

DOI: 10.3238/arztebl.2014.0367

Abstract

Anaphylaxis is the most severe manifestation of a mast cell-dependent immediate reaction and may be fatal. According to data from the Berlin region, its incidence is 2-3 cases per 100 000 persons per year.We evaluated data from the anaphylaxis registry of the German-speaking countries for 2006-2013 and data from the protocols of the ADAC air rescue service for 2010-2011 to study the triggers, clinical manifestations, and treatment of anaphylaxis.The registry contained data on 4141 patients, and the ADAC air rescue protocols concerned 1123 patients. In the registry, the most common triggers for anaphylaxis were insect venom (n = 2074; 50.1%), foods (n = 1039; 25.1%), and drugs (n = 627; 15.1%). Within these groups, the most common triggers were wasp (n = 1460) and bee stings (n = 412), legumes (n = 241), animal proteins (n = 225), and analgesic drugs (n = 277). Food anaphylaxis was most frequently induced by peanuts, cow milk, and hen's egg in children and by wheat and shellfish in adults. An analysis of the medical emergency cases revealed that epinephrine was given for grade 3 or 4 anaphylaxis to 14.5% and 43.9% (respectively) of the patients in the anaphylaxis registry and to 19% and 78% of the patients in the air rescue protocols.Wasp and bee venom, legumes, animal proteins, and analgesic drugs were the commonest triggers of anaphylaxis. Their relative frequency was age-dependent. Epinephrine was given too rarely, as it is recommended in the guidelines for all cases of grade 2 and above.

Authors with CRIS profile

Vera Mahler Medizinische Fakultät

Involved external institutions

Charité - Universitätsmedizin Berlin DE Germany (DE) Allgemeiner Deutscher Automobil-Club (ADAC) DE Germany (DE) Medizinische Universität Graz AT Austria (AT) Paracelsus Medizinische Privatuniversität AT Austria (AT) Universitäts-Kinderspital Zürich CH Switzerland (CH) Kinderzentrum Dresden-Friedrichstadt GbR DE Germany (DE) Universität des Saarlandes (UdS) DE Germany (DE) Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH DE Germany (DE) Friedrich-Schiller-Universität Jena DE Germany (DE) Universität zu Köln DE Germany (DE) Universitätsspital Basel CH Switzerland (CH) Universität Leipzig DE Germany (DE) Ludwig-Maximilians-Universität (LMU) DE Germany (DE)

How to cite

APA:

Worm, M., Eckermann, O., Doelle, S., Aberer, W., Beyer, K., Hawranek, T.,... Rueff, F. (2014). Triggers and treatment of anaphylaxis: an analysis of 4,000 cases from Germany, Austria and Switzerland. Deutsches Ärzteblatt international, 111(21), 367-75. https://doi.org/10.3238/arztebl.2014.0367

MLA:

Worm, Margitta, et al. "Triggers and treatment of anaphylaxis: an analysis of 4,000 cases from Germany, Austria and Switzerland." Deutsches Ärzteblatt international 111.21 (2014): 367-75.

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