The Experts below are selected from a list of 19515 Experts worldwide ranked by ideXlab platform
John B Ziegler - One of the best experts on this subject based on the ideXlab platform.
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prediction of Anaphylaxis during peanut food challenge usefulness of the peanut skin prick test spt and specific ige level
Pediatric Allergy and Immunology, 2010Co-Authors: Brynn Wainstein, Jennie Studdert, Mary Ziegler, John B ZieglerAbstract:Wainstein BK, Studdert J, Ziegler, M, Ziegler JB. Prediction of Anaphylaxis during peanut food challenge: usefulness of the peanut skin prick test (SPT) and specific IgE level. Pediatr Allergy Immunol 2010: 21: 603–611. © 2010 John Wiley & Sons A/S Cutoffs (decision points) of the peanut skin prick test (SPT) and specific IgE level for predicting peanut allergy have been proposed. It is not known whether decision points indicating a significant risk of severe reactions on challenge differ from those indicating probable allergy. We aimed at determining the usefulness of allergy tests for predicting the risk of Anaphylaxis on challenge following the ingestion of up to 12 g of peanut in peanut-sensitized children. Children attending the Allergy Clinic who had a positive peanut SPT and completed open-label in-hospital peanut challenges were included. The challenge protocol provided for challenges to be continued beyond initial mild reactions. Eighty-nine in-hospital peanut challenges were performed. Thirty-four were excluded as the challenge was not completed, leaving 55 for analysis. Children who completed the challenge and did not react (n = 28) or reacted without Anaphylaxis (n = 6) represented the comparison group (n = 34). The study group comprised 21 children whose challenge resulted in Anaphylaxis. The mean peanut SPT wheal size and specific IgE level were associated with the severity of reactions on challenge. Among the 21 children, who developed Anaphylaxis, in only 3 cases was Anaphylaxis the initial reaction. Unexpectedly, a history of Anaphylaxis was not predictive of Anaphylaxis on challenge. Anaphylaxis developed at cumulative doses of peanut ranging from 0.02 to 11.7 g. Provided that a fixed amount of peanut is ingested, available tests for peanut allergy may assist in predicting the risk of Anaphylaxis during challenge in peanut-sensitized children.
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prediction of Anaphylaxis during peanut food challenge usefulness of the peanut skin prick test spt and specific ige level
Pediatric Allergy and Immunology, 2010Co-Authors: Brynn Wainstein, Jennie Studdert, Mary Ziegler, John B ZieglerAbstract:Cutoffs (decision points) of the peanut skin prick test (SPT) and specific IgE level for predicting peanut allergy have been proposed. It is not known whether decision points indicating a significant risk of severe reactions on challenge differ from those indicating probable allergy. We aimed at determining the usefulness of allergy tests for predicting the risk of Anaphylaxis on challenge following the ingestion of up to 12 g of peanut in peanut-sensitized children. Children attending the Allergy Clinic who had a positive peanut SPT and completed open-label in-hospital peanut challenges were included. The challenge protocol provided for challenges to be continued beyond initial mild reactions. Eighty-nine in-hospital peanut challenges were performed. Thirty-four were excluded as the challenge was not completed, leaving 55 for analysis. Children who completed the challenge and did not react (n = 28) or reacted without Anaphylaxis (n = 6) represented the comparison group (n = 34). The study group comprised 21 children whose challenge resulted in Anaphylaxis. The mean peanut SPT wheal size and specific IgE level were associated with the severity of reactions on challenge. Among the 21 children, who developed Anaphylaxis, in only 3 cases was Anaphylaxis the initial reaction. Unexpectedly, a history of Anaphylaxis was not predictive of Anaphylaxis on challenge. Anaphylaxis developed at cumulative doses of peanut ranging from 0.02 to 11.7 g. Provided that a fixed amount of peanut is ingested, available tests for peanut allergy may assist in predicting the risk of Anaphylaxis during challenge in peanut-sensitized children.
Estelle F R Simons - One of the best experts on this subject based on the ideXlab platform.
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guiding principles for the recognition diagnosis and management of infants with Anaphylaxis an expert panel consensus
The Journal of Allergy and Clinical Immunology: In Practice, 2019Co-Authors: Matthew Greenhawt, Estelle F R Simons, Carlos A Camargo, Michael Pistiner, R Gupta, Allen J Meadows, Jonathan M Spergel, Philip LiebermanAbstract:Infant Anaphylaxis is an emerging risk, with food allergy the most common cause. Although the presentation of Anaphylaxis involves the same systems as in older children and adults, there are real-world challenges to identifying symptoms of an allergic emergency in nonverbal children, as well as implementing optimal treatment. Recognition of Anaphylaxis in infants can be challenging because allergic symptoms and certain normal infant behaviors may overlap. Intramuscular epinephrine is the treatment of choice for infants, as it is for older children and adults, and an epinephrine autoinjector approved by the Food and Drug Administration is now available for infants weighing between 7.5 and 15 kg. A panel of experts sought to develop guiding principles for the recognition, diagnosis, and management of Anaphylaxis in infants, and provide a framework for the development of new guidelines and future research. Accordingly, Anaphylaxis emergency action planning for infants was addressed by the panel. In considering formation of future infant Anaphylaxis guidelines, health care providers should be aware of the needs to improve the recognition, diagnosis, and management of infants with Anaphylaxis. Future research should identify and validate clinical criteria for the diagnosis of Anaphylaxis in infants, as well as risk factors for the most severe reactions.
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epinephrine for first aid management of Anaphylaxis
Pediatrics, 2017Co-Authors: Sco H Sichere, Estelle F R Simons, Section O AllergyAbstract:Anaphylaxis is a severe, generalized allergic or hypersensitivity reaction that is rapid in onset and may cause death. Epinephrine (adrenaline) can be life-saving when administered as rapidly as possible once Anaphylaxis is recognized. This clinical report from the American Academy of Pediatrics is an update of the 2007 clinical report on this topic. It provides information to help clinicians identify patients at risk of Anaphylaxis and new information about epinephrine and epinephrine autoinjectors (EAs). The report also highlights the importance of patient and family education about the recognition and management of Anaphylaxis in the community. Key points emphasized include the following: (1) validated clinical criteria are available to facilitate prompt diagnosis of Anaphylaxis; (2) prompt intramuscular epinephrine injection in the mid-outer thigh reduces hospitalizations, morbidity, and mortality; (3) prescribing EAs facilitates timely epinephrine injection in community settings for patients with a history of Anaphylaxis and, if specific circumstances warrant, for some high-risk patients who have not previously experienced Anaphylaxis; (4) prescribing epinephrine for infants and young children weighing <15 kg, especially those who weigh 7.5 kg and under, currently presents a dilemma, because the lowest dose available in EAs, 0.15 mg, is a high dose for many infants and some young children; (5) effective management of Anaphylaxis in the community requires a comprehensive approach involving children, families, preschools, schools, camps, and sports organizations; and (6) prevention of Anaphylaxis recurrences involves confirmation of the trigger, discussion of specific allergen avoidance, allergen immunotherapy (eg, with stinging insect venom, if relevant), and a written, personalized Anaphylaxis emergency action plan; and (7) the management of Anaphylaxis also involves education of children and supervising adults about Anaphylaxis recognition and first-aid treatment.
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2015 update of the evidence base world allergy organization Anaphylaxis guidelines
World Allergy Organization Journal, 2015Co-Authors: Estelle F R Simons, Margitta Worm, Luciana Kase Tanno, Yehia M Elgamal, M Sanchezborges, Bernard Yuhor Thong, Motohiro Ebisawa, Richard F Lockey, Simon G A Brown, Haesim ParkAbstract:The World Allergy Organization (WAO) Guidelines for the assessment and management of Anaphylaxis provide a unique global perspective on this increasingly common, potentially life-threatening disease. Recommendations made in the original WAO Anaphylaxis Guidelines remain clinically valid and relevant, and are a widely accessed and frequently cited resource. In this 2015 update of the evidence supporting recommendations in the Guidelines, new information based on Anaphylaxis publications from January 2014 through mid- 2015 is summarized. Advances in epidemiology, diagnosis, and management in healthcare and community settings are highlighted. Additionally, new information about patient factors that increase the risk of severe and/or fatal Anaphylaxis and patient co-factors that amplify anaphylactic episodes is presented and new information about Anaphylaxis triggers and confirmation of triggers to facilitate specific trigger avoidance and immunomodulation is reviewed. The update includes tables summarizing important advances in Anaphylaxis research.
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h2 antihistamines for the treatment of Anaphylaxis with and without shock a systematic review
Annals of Allergy Asthma & Immunology, 2014Co-Authors: Ulugbek Nurmatov, Estelle F R Simons, Aziz Sheikh, Edmund RhatiganAbstract:Abstract Background Anaphylaxis is a serious allergic or hypersensitivity reaction, which is rapid in onset and sometimes can prove fatal. Although H 2 -antihistamines are often administered for emergency treatment in Anaphylaxis, there is uncertainty about their effectiveness in this disease. Objective To assess the benefits and harms of H 2 -antihistamines in the treatment of Anaphylaxis. Methods A systematic review was performed of randomized controlled trials and quasi-randomized controlled trials comparing H 2 -antihistamines with placebo or no intervention in patients with Anaphylaxis. Results The authors failed to identify any eligible studies for inclusion in this systematic review. Conclusion When H 2 -antihistamines are recommended for Anaphylaxis treatment, the status of the evidence base supporting their use should be described. Well-designed randomized controlled trials investigating the role of H 2 -antihistamines in Anaphylaxis treatment are urgently needed.
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world allergy organization Anaphylaxis guidelines summary
The Journal of Allergy and Clinical Immunology, 2011Co-Authors: Estelle F R Simons, Ledit R F Ardusso, Beatrice M Bilo, Yehia M Elgamal, Dennis K Ledford, Johannes Ring, M Sanchezborges, Gianenrico Senna, Aziz Sheikh, Bernard Yuhor ThongAbstract:The uniqueWorld Allergy Organization (WAO) Guidelines for the Assessment and Management of Anaphylaxis were created in response to the absence of global guidelines for Anaphylaxis. They were developed after documenting that essential medications, supplies, and equipment for assessment andmanagement of Anaphylaxis are not universally available worldwide. Additionally, they were developed with the awareness that any health care professional might, at some time, have to assess and manage Anaphylaxis in a low-resource environment, whether this be a country, a region, or a specific location, such as an aircraft cabin or a remote area. They incorporate contributions frommore than 100 allergy/immunology specialists on 6 continents received through the WAO member societies and the WAO Board of Directors. In order to transcend language barriers, the principles of Anaphylaxis assessment and management set forth in the guidelines are summarized in 5 comprehensive illustrations. The guidelines review patients’ risk factors for severe or fatal Anaphylaxis, cofactors that amplify Anaphylaxis, and Anaphylaxis in vulnerable patients, such as pregnant women, infants, and the
Brynn Wainstein - One of the best experts on this subject based on the ideXlab platform.
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increases in Anaphylaxis fatalities in australia from 1997 to 2013
Clinical & Experimental Allergy, 2016Co-Authors: Raymond J Mullins, Brynn Wainstein, Woei Kang Liew, Dianne E Campbell, Elizabeth H BarnesAbstract:SummaryBackground Recent epidemiological studies indicate increases in Australian, UK and US hospital Anaphylaxis admission rates. Objectives The aim of this study was to determine whether Australian Anaphylaxis fatalities are increasing in parallel and to examine the characteristics of fatalities recorded in the National Coronial Information System (NCIS). Methods Time trends in Australian Anaphylaxis fatalities were examined using data derived from the Australian Bureau of Statistics (ABS) 1997–2013 and the NCIS 2000–2013, the latter providing additional information to verify cause and identify risk factors. Results The ABS recorded 324 Anaphylaxis fatalities by cause: unspecified (n = 205); medication (n = 52); insect stings/tick bites (n = 41); food (n = 23); and blood products (n = 3). From 1997 to 2013, all-cause fatal Anaphylaxis rates increased by 6.2%/year (95% CI: 3.8–8.6%, P < 0.0001) or from 0.054% to 0.099/105 population. Fatal food Anaphylaxis increased by 9.7%/year (95% CI: 0.25–20%, P = 0.04) and unspecified Anaphylaxis deaths by 7.8% (95% CI: 4.6–11.0, P < 0.0001). There was an insignificant change in medication-related fatalities (5.6% increase/year; 95% CI: 0.3% decrease to 11.8% increase, P = 0.06), and sting/bite fatalities remained unchanged. Hospital Anaphylaxis admission rates for all-cause, food, unspecified and medication Anaphylaxis increased at rates of 8%, 10%, 4.4% and 6.8%/year, respectively. A total of 147 verified NCIS deaths were examined in detail: medication- and sting/bite-related fatalities occurred predominantly in older individuals with multiple comorbidities. Upright posture after Anaphylaxis was associated with risk of sudden death (all causes). Seafood (not nuts) was the most common trigger for food-related Anaphylaxis deaths. Conclusions Australian Anaphylaxis fatality rates (most causes) have increased over the last 16 years, contrasting with UK- and US-based studies that describe overall lower and static overall Anaphylaxis fatality rates (0.047–0.069/105 population).
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prediction of Anaphylaxis during peanut food challenge usefulness of the peanut skin prick test spt and specific ige level
Pediatric Allergy and Immunology, 2010Co-Authors: Brynn Wainstein, Jennie Studdert, Mary Ziegler, John B ZieglerAbstract:Wainstein BK, Studdert J, Ziegler, M, Ziegler JB. Prediction of Anaphylaxis during peanut food challenge: usefulness of the peanut skin prick test (SPT) and specific IgE level. Pediatr Allergy Immunol 2010: 21: 603–611. © 2010 John Wiley & Sons A/S Cutoffs (decision points) of the peanut skin prick test (SPT) and specific IgE level for predicting peanut allergy have been proposed. It is not known whether decision points indicating a significant risk of severe reactions on challenge differ from those indicating probable allergy. We aimed at determining the usefulness of allergy tests for predicting the risk of Anaphylaxis on challenge following the ingestion of up to 12 g of peanut in peanut-sensitized children. Children attending the Allergy Clinic who had a positive peanut SPT and completed open-label in-hospital peanut challenges were included. The challenge protocol provided for challenges to be continued beyond initial mild reactions. Eighty-nine in-hospital peanut challenges were performed. Thirty-four were excluded as the challenge was not completed, leaving 55 for analysis. Children who completed the challenge and did not react (n = 28) or reacted without Anaphylaxis (n = 6) represented the comparison group (n = 34). The study group comprised 21 children whose challenge resulted in Anaphylaxis. The mean peanut SPT wheal size and specific IgE level were associated with the severity of reactions on challenge. Among the 21 children, who developed Anaphylaxis, in only 3 cases was Anaphylaxis the initial reaction. Unexpectedly, a history of Anaphylaxis was not predictive of Anaphylaxis on challenge. Anaphylaxis developed at cumulative doses of peanut ranging from 0.02 to 11.7 g. Provided that a fixed amount of peanut is ingested, available tests for peanut allergy may assist in predicting the risk of Anaphylaxis during challenge in peanut-sensitized children.
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prediction of Anaphylaxis during peanut food challenge usefulness of the peanut skin prick test spt and specific ige level
Pediatric Allergy and Immunology, 2010Co-Authors: Brynn Wainstein, Jennie Studdert, Mary Ziegler, John B ZieglerAbstract:Cutoffs (decision points) of the peanut skin prick test (SPT) and specific IgE level for predicting peanut allergy have been proposed. It is not known whether decision points indicating a significant risk of severe reactions on challenge differ from those indicating probable allergy. We aimed at determining the usefulness of allergy tests for predicting the risk of Anaphylaxis on challenge following the ingestion of up to 12 g of peanut in peanut-sensitized children. Children attending the Allergy Clinic who had a positive peanut SPT and completed open-label in-hospital peanut challenges were included. The challenge protocol provided for challenges to be continued beyond initial mild reactions. Eighty-nine in-hospital peanut challenges were performed. Thirty-four were excluded as the challenge was not completed, leaving 55 for analysis. Children who completed the challenge and did not react (n = 28) or reacted without Anaphylaxis (n = 6) represented the comparison group (n = 34). The study group comprised 21 children whose challenge resulted in Anaphylaxis. The mean peanut SPT wheal size and specific IgE level were associated with the severity of reactions on challenge. Among the 21 children, who developed Anaphylaxis, in only 3 cases was Anaphylaxis the initial reaction. Unexpectedly, a history of Anaphylaxis was not predictive of Anaphylaxis on challenge. Anaphylaxis developed at cumulative doses of peanut ranging from 0.02 to 11.7 g. Provided that a fixed amount of peanut is ingested, available tests for peanut allergy may assist in predicting the risk of Anaphylaxis during challenge in peanut-sensitized children.
Aziz Sheikh - One of the best experts on this subject based on the ideXlab platform.
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drug induced Anaphylaxis documented in electronic health records
The Journal of Allergy and Clinical Immunology: In Practice, 2019Co-Authors: Aziz Sheikh, Neil Dhopeshwarkar, Raymond Doan, Maxim Topaz, David W Bates, Kimberly G Blumenthal, Li ZhouAbstract:Background Although drugs represent a common cause of Anaphylaxis, few large studies of drug-induced Anaphylaxis have been performed. Objective To describe the epidemiology and validity of reported drug-induced Anaphylaxis in the electronic health records (EHRs) of a large United States health care system. Methods Using EHR drug allergy data from 1995 to 2013, we determined the population prevalence of Anaphylaxis including Anaphylaxis prevalence over time, and the most commonly implicated drugs/drug classes reported to cause Anaphylaxis. Patient risk factors for drug-induced Anaphylaxis were assessed using a logistic regression model. Serum tryptase and allergist visits were used to assess the validity and follow-up of EHR-reported Anaphylaxis. Results Among 1,756,481 patients, 19,836 (1.1%) reported drug-induced Anaphylaxis; penicillins (45.9 per 10,000), sulfonamide antibiotics (15.1 per 10,000), and nonsteroidal anti-inflammatory drugs (NSAIDs) (13.0 per 10,000) were most commonly implicated. Patients with white race (odds ratio [OR] 2.38, 95% CI 2.27-2.49), female sex (OR 2.20, 95% CI 2.13-2.28), systemic mastocytosis (OR 4.60, 95% CI 2.66-7.94), Sjogren's syndrome (OR 1.94, 95% CI 1.47-2.56), and asthma (OR 1.50, 95% CI 1.43-1.59) had an increased odds of drug-induced Anaphylaxis. Serum tryptase was performed in 135 ( Conclusions EHR-reported Anaphylaxis occurred in approximately 1% of patients, most commonly from penicillins, sulfonamide antibiotics, and NSAIDs. Females, whites, and patients with mastocytosis, Sjogren's syndrome, and asthma had increased odds of reporting drug-induced Anaphylaxis. The low observed frequency of tryptase testing and specialist evaluation emphasize the importance of educating providers on Anaphylaxis management.
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h2 antihistamines for the treatment of Anaphylaxis with and without shock a systematic review
Annals of Allergy Asthma & Immunology, 2014Co-Authors: Ulugbek Nurmatov, Estelle F R Simons, Aziz Sheikh, Edmund RhatiganAbstract:Abstract Background Anaphylaxis is a serious allergic or hypersensitivity reaction, which is rapid in onset and sometimes can prove fatal. Although H 2 -antihistamines are often administered for emergency treatment in Anaphylaxis, there is uncertainty about their effectiveness in this disease. Objective To assess the benefits and harms of H 2 -antihistamines in the treatment of Anaphylaxis. Methods A systematic review was performed of randomized controlled trials and quasi-randomized controlled trials comparing H 2 -antihistamines with placebo or no intervention in patients with Anaphylaxis. Results The authors failed to identify any eligible studies for inclusion in this systematic review. Conclusion When H 2 -antihistamines are recommended for Anaphylaxis treatment, the status of the evidence base supporting their use should be described. Well-designed randomized controlled trials investigating the role of H 2 -antihistamines in Anaphylaxis treatment are urgently needed.
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World Allergy Organization Guidelines for the Assessment and Management of Anaphylaxis
World Allergy Organization Journal, 2011Co-Authors: F. Estelle R. Simons, Ledit R F Ardusso, Dennis K Ledford, Johannes Ring, Gianenrico Senna, Aziz Sheikh, M. Beatrice Bilò, Yehia M. El-gamal, Mario Sanchez-borges, Bernard Yuhor ThongAbstract:The illustrated World Allergy Organization (WAO) Anaphylaxis Guidelines were created in response to absence of global guidelines for Anaphylaxis. Uniquely, before they were developed, lack of worldwide availability of essentials for the diagnosis and treatment of Anaphylaxis was documented. They incorporate contributions from more than 100 allergy/immunology specialists on 6 continents. Recommendations are based on the best evidence available, supported by references published to the end of December 2010. The Guidelines review patient risk factors for severe or fatal Anaphylaxis, co-factors that amplify Anaphylaxis, and Anaphylaxis in vulnerable patients, including pregnant women, infants, the elderly, and those with cardiovascular disease. They focus on the supreme importance of making a prompt clinical diagnosis and on the basic initial treatment that is urgently needed and should be possible even in a low resource environment. This involves having a written emergency protocol and rehearsing it regularly; then, as soon as Anaphylaxis is diagnosed, promptly and simultaneously calling for help, injecting epinephrine (adrenaline) intramuscularly, and placing the patient on the back or in a position of comfort with the lower extremities elevated. When indicated, additional critically important steps include administering supplemental oxygen and maintaining the airway, establishing intravenous access and giving fluid resuscitation, and initiating cardiopulmonary resuscitation with continuous chest compressions. Vital signs and cardiorespiratory status should be monitored frequently and regularly (preferably, continuously). The Guidelines briefly review management of Anaphylaxis refractory to basic initial treatment. They also emphasize preparation of the patient for self-treatment of Anaphylaxis recurrences in the community, confirmation of Anaphylaxis triggers, and prevention of recurrences through trigger avoidance and immunomodulation. Novel strategies for dissemination and implementation are summarized. A global agenda for Anaphylaxis research is proposed.
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world allergy organization Anaphylaxis guidelines summary
The Journal of Allergy and Clinical Immunology, 2011Co-Authors: Estelle F R Simons, Ledit R F Ardusso, Beatrice M Bilo, Yehia M Elgamal, Dennis K Ledford, Johannes Ring, M Sanchezborges, Gianenrico Senna, Aziz Sheikh, Bernard Yuhor ThongAbstract:The uniqueWorld Allergy Organization (WAO) Guidelines for the Assessment and Management of Anaphylaxis were created in response to the absence of global guidelines for Anaphylaxis. They were developed after documenting that essential medications, supplies, and equipment for assessment andmanagement of Anaphylaxis are not universally available worldwide. Additionally, they were developed with the awareness that any health care professional might, at some time, have to assess and manage Anaphylaxis in a low-resource environment, whether this be a country, a region, or a specific location, such as an aircraft cabin or a remote area. They incorporate contributions frommore than 100 allergy/immunology specialists on 6 continents received through the WAO member societies and the WAO Board of Directors. In order to transcend language barriers, the principles of Anaphylaxis assessment and management set forth in the guidelines are summarized in 5 comprehensive illustrations. The guidelines review patients’ risk factors for severe or fatal Anaphylaxis, cofactors that amplify Anaphylaxis, and Anaphylaxis in vulnerable patients, such as pregnant women, infants, and the
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trends in national incidence lifetime prevalence and adrenaline prescribing for Anaphylaxis in england
Journal of the Royal Society of Medicine, 2008Co-Authors: Aziz Sheikh, Julia Hippisleycox, J M Newton, Justin FentyAbstract:Summary Background Analysis of primary healthcare datasets offers the possibility to increase understanding of the epidemiology of acute uncommon conditions such as Anaphylaxis, but these datasets remain under-exploited. Aim To investigate recent trends in the recorded incidence, lifetime prevalence and prescribing of adrenaline for Anaphylaxis in England. Methods QRESEARCH is one of the world’s largest national aggregated health databases containing the records of over nine million patients.We extracted data on all patients with a recorded diagnosis of Anaphylaxis and calculated annual age-sex standardized incidence and lifetime period prevalence rates for each year from 2001–2005.We also analysed trends in adrenaline prescribing in those with a recorded diagnosis of Anaphylaxis. National population figures were used to estimate numbers of people in England that have experienced Anaphylaxis at some point in their lives. Results The age-sex standardized incidence of Anaphylaxis was 6.7 per 100,000 person-years in 2001 and increased by 19% to 7.9 in 2005. Lifetime age-sex standardized prevalence of a recorded diagnosis of Anaphylaxis was 50.0 per 100,000 in 2001 and increased by 51% to 75.5 in 2005. Prescribing of adrenaline increased by 97% over this period. By the end of 2005 there were an estimated 37,800 people that had experienced Anaphylaxis at some point in their lives. Conclusions Recorded incidence, lifetime prevalence and prescribing of adrenaline for Anaphylaxis all showed substantial increases in recent years. An estimated 1 in 1,333 of the English population have at some point in their lives experienced Anaphylaxis.
Paul Turner - One of the best experts on this subject based on the ideXlab platform.
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global trends in Anaphylaxis epidemiology and clinical implications
The Journal of Allergy and Clinical Immunology: In Practice, 2020Co-Authors: Dianne E Campbell, Paul Turner, Megan S Motosue, Ronna L CampbellAbstract:The true global scale of Anaphylaxis remains elusive, because many episodes occur in the community without presentation to health care facilities, and most regions have not yet developed reliable systems with which to monitor severe allergic events. The most robust data sets currently available are based largely on hospital admissions, which are limited by inherent issues of misdiagnosis, misclassification, and generalizability. Despite this, there is convincing evidence of a global increase in rates of all-cause Anaphylaxis, driven largely by medication- and food-related Anaphylaxis. There is no evidence of parallel increases in global all-cause Anaphylaxis mortality, with surprisingly similar estimates for case-fatality rates at approximately 0.5% to 1% of fatal outcomes for hospitalizations due to Anaphylaxis across several regions. Studying regional patterns of Anaphylaxis to certain triggers have provided valuable insights into susceptibility and sensitizing events: for example, the link between the mAb cetuximab and allergy to mammalian meat. Likewise, data from published fatality registers can identify potentially modifiable risk factors that can be used to inform clinical practice, such as prevention of delayed epinephrine administration, correct posturing during Anaphylaxis, special attention to populations at risk (such as the elderly on multiple medications), and use of venom immunotherapy in individuals at risk of insect-related Anaphylaxis.
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time to revisit the definition and clinical criteria for Anaphylaxis
World Allergy Organization Journal, 2019Co-Authors: Paul Turner, Margitta Worm, Ignacio J Ansotegui, Yehia Elgamal, Montserrat Fernandez Rivas, Stanley M Fineman, Mario Geller, Alexei Gonzalezestrada, Paul A GreenbergerAbstract:The WAO Anaphylaxis Committee present to our global colleagues the above definition and clinical criteria for the diagnosis of Anaphylaxis, our aim being to better capture the reality of Anaphylaxis presentations, simplify diagnosis and therefore improve the management of Anaphylaxis.
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food induced fatal Anaphylaxis from epidemiological data to general prevention strategies
Clinical & Experimental Allergy, 2018Co-Authors: G Pouessel, Paul Turner, Margitta Worm, Victoria Cardona, A Deschildre, Etienne Beaudouin, Jeanmarie Renaudin, P Demoly, Luciana Kase TannoAbstract:Background Anaphylaxis hospitalizations are increasing in many countries, in particular for medication and food triggers in young children. Food-related Anaphylaxis remains an uncommon cause of death, but a significant proportion of these are preventable. Aim To review published epidemiological data relating to food-induced Anaphylaxis and potential risk factors of fatal and/or near-fatal Anaphylaxis cases, in order to provide strategies to reduce the risk of severe adverse outcomes in food Anaphylaxis. Methods We identified 32 published studies available in MEDLINE (1966-2017), EMBASE (1980-2017), CINAHL (1982-2017), using known terms and synonyms suggested by librarians and allergy specialists. Results Young adults with a history of asthma, previously known food allergy particularly to peanut/tree nuts are at higher risk of fatal Anaphylaxis reactions. In some countries, cow's milk and seafood/fish are also becoming common triggers of fatal reactions. Delayed adrenaline injection is associated with fatal outcomes, but timely adrenaline alone may be insufficient. There is still a lack of evidence regarding the real impact of these risk factors and co-factors (medications and/or alcohol consumption, physical activities, and mast cell disorders). Conclusions General strategies should include optimization of the classification and coding for Anaphylaxis (new ICD 11 Anaphylaxis codes), dissemination of international recommendations on the treatment of Anaphylaxis, improvement of the prevention in food and catering areas, and dissemination of specific policies for allergic children in schools. Implementation of these strategies will involve national and international support for ongoing local efforts in relationship with networks of centres of excellence to provide personalized management (which might include immunotherapy) for the most at-risk patients.
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fatal Anaphylaxis mortality rate and risk factors
The Journal of Allergy and Clinical Immunology: In Practice, 2017Co-Authors: Paul Turner, Dianne E Campbell, Elina Jerschow, Thisanayagam Umasunthar, Robert Y Lin, Robert J BoyleAbstract:Up to 5% of the US population has suffered Anaphylaxis. Fatal outcome is rare, such that even for people with known venom or food allergy, fatal Anaphylaxis constitutes less than 1% of total mortality risk. The incidence of fatal Anaphylaxis has not increased in line with hospital admissions for Anaphylaxis. Fatal drug Anaphylaxis may be increasing, but rates of fatal Anaphylaxis to venom and food are stable. Risk factors for fatal Anaphylaxis vary according to cause. For fatal drug Anaphylaxis, previous cardiovascular morbidity and older age are risk factors, with beta-lactam antibiotics, general anesthetic agents, and radiocontrast injections the commonest triggers. Fatal food Anaphylaxis most commonly occurs during the second and third decades. Delayed epinephrine administration is a risk factor; common triggers are nuts, seafood, and in children, milk. For fatal venom Anaphylaxis, risk factors include middle age, male sex, white race, cardiovascular disease, and possibly mastocytosis; insect triggers vary by region. Upright posture is a feature of fatal Anaphylaxis to both food and venom. The rarity of fatal Anaphylaxis and the significant quality of life impact of allergic conditions suggest that quality of life impairment should be a key consideration when making treatment decisions in patients at risk for Anaphylaxis.
