| Predictors of severe systemic anaphylactic reactions in patients with Hymenoptera venom allergy: importance of baseline serum tryptase-a study of the European Academy of Allergology and Clinical Immunology Interest Group on Insect Venom Hypersensitivity. | |
| | |
MedLine Citation:
|
PMID: 19895993 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Severe anaphylaxis to honeybee or vespid stings is associated with a variety of risk factors, which are poorly defined. OBJECTIVE: Our aim was to evaluate the association of baseline serum tryptase concentrations and other variables routinely recorded during patient evaluation with the frequency of past severe anaphylaxis after a field sting. METHODS: In this observational multicenter study, we enrolled 962 patients with established bee or vespid venom allergy who had a systemic reaction after a field sting. Data were collected on tryptase concentration, age, sex, culprit insect, cardiovascular medication, and the number of preceding minor systemic reactions before the index field sting. A severe reaction was defined as anaphylactic shock, loss of consciousness, or cardiopulmonary arrest. The index sting was defined as the hitherto first, most severe systemic field-sting reaction. Relative rates were calculated with generalized additive models. RESULTS: Two hundred six (21.4%) patients had a severe anaphylactic reaction after a field sting. The frequency of this event increased significantly with higher tryptase concentrations (nonlinear association). Other factors significantly associated with severe reactions after a field sting were vespid venom allergy, older age, male sex, angiotensin-converting enzyme inhibitor medication, and 1 or more preceding field stings with a less severe systemic reaction. CONCLUSION: In patients with honeybee or vespid venom allergy, baseline serum tryptase concentrations are associated with the risk for severe anaphylactic reactions. Preventive measures should include substitution of angiotensin-converting enzyme inhibitors. |
| | |
Authors:
|
Franziska Ru?ff; Bernhard Przybilla; Maria Beatrice Bil?; Ulrich M?ller; Fabian Scheipl; Werner Aberer; Jo?lle Birnbaum; Anna Bodzenta-Lukaszyk; Floriano Bonifazi; Christoph Bucher; Paolo Campi; Ulf Darsow; Cornelia Egger; Gabrielle Haeberli; Thomas Hawranek; Michael K?rner; Iwona Kucharewicz; Helmut K?chenhoff; Roland Lang; Oliviero Quercia; Norbert Reider; Maurizio Severino; Michael Sticherling; Gunter Johannes Sturm; Brunello W?thrich |
Related Documents
:
|
1018353 - Jarisch-herxheimer reaction. case report. 11449533 - Immediate reaction to clarithromycin. 10187813 - Oxidation of methionine residues in antithrombin. effects on biological activity and he... |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: The Journal of allergy and clinical immunology Volume: 124 ISSN: 1097-6825 ISO Abbreviation: J. Allergy Clin. Immunol. Publication Date: 2009 Nov |
Date Detail:
|
Created Date: 2009-11-09 Completed Date: 2009-11-24 Revised Date: 2010-05-10 |
Medline Journal Info:
|
Nlm Unique ID: 1275002 Medline TA: J Allergy Clin Immunol Country: United States |
Other Details:
|
Languages: eng Pagination: 1047-54 Citation Subset: AIM; IM |
Affiliation:
|
Department of Dermatology and Allergology, Ludwig-Maximilians-Universit?t, Munich, Germany. Franziska.Rueff@med.uni-muenchen.de |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Anaphylaxis / blood, enzymology, epidemiology* Animals Bee Venoms / immunology* Cohort Studies Female Humans Hypersensitivity / immunology* Insect Bites and Stings / immunology* Male Middle Aged Prognosis Prospective Studies Retrospective Studies Tryptases / blood* Wasps / immunology* |
| Chemical | |
Reg. No./Substance:
|
0/Bee Venoms; EC 3.4.21.59/Tryptases |
| Comments/Corrections | |
Comment In:
|
J Allergy Clin Immunol. 2010 May;125(5):1171; author reply 1171-2
[PMID:
20347124
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Maternal peanut exposure during pregnancy and lactation reduces peanut allergy risk in offspring.
Next Document: Outcomes of patients with severe combined immunodeficiency treated with hematopoietic stem cell tran...