Document Detail

Fatal anaphylaxis in the UK, 1992-2001.
MedLine Citation:
PMID:  15025395     Owner:  NLM     Status:  MEDLINE    
Each year in the UK, around nine deaths are attributed to anaphylaxis to pharmaceuticals, six to food and four to stings. I have identified 214 deaths associated with anaphylaxis, and have sufficient information for 196 to determine that 88 deaths were due to shock, 96 to asphyxia. Five deaths followed epinephrine overdose, seven were complicated by disseminated intravascular coagulation. There will have been other unrecognized fatal antibiotic and asthmatic food reactions. For foods, peak age was 17-27 with a female and atopic predominance; the first arrest was commonly from asthma 25-35 minutes after the implicated food. For stings, peak age was 45-70 with male and non-atopic predominance; death was commonly from shock 10-15 minutes after the sting. A majority of deaths from pharmaceuticals in hospital took 5 minutes or less from dose to arrest; peak age was 60-75. Maximum time for any cause from trigger to first arrest was 6 hours. The danger of epinephrine overdose and its limitations in reversing anaphylaxis must be recognized. The patient should remain supine with legs raised throughout sting and other shock reactions. Prevention of fatal food reactions will depend on avoidance and optimal daily control of asthma.
Richard S H Pumphrey
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Novartis Foundation symposium     Volume:  257     ISSN:  1528-2511     ISO Abbreviation:  Novartis Found. Symp.     Publication Date:  2004  
Date Detail:
Created Date:  2004-03-17     Completed Date:  2004-05-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9807767     Medline TA:  Novartis Found Symp     Country:  England    
Other Details:
Languages:  eng     Pagination:  116-28; discussion 128-32, 157-60, 276-85     Citation Subset:  IM    
Immunology Unit, Central Manchester Healthcare NHS Trust Hospitals, St Mary's Hospital, Hathersage Road, Manchester M13 0JH, UK.
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MeSH Terms
Anaphylaxis / epidemiology,  mortality*,  physiopathology,  therapy
Cause of Death
Child, Preschool
Great Britain / epidemiology
Middle Aged
Retrospective Studies
Risk Factors
Shock / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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