Journal article

Publication year: 2021

Pages: 653-65+

Journal: Journal of Allergy and Clinical Immunology

Volume number: 147

Issue number: 2

ISSN: 0091-6749

eISSN: 1097-6825

Open access status: Green

DOI Link: https://doi.org/10.1016/j.jaci.2020.06.008

Publisher: Elsevier

Abstract: 

Background: Venom-induced anaphylaxis (VIA) is a common, potentially life-threatening hypersensitivity reaction associated with (1) a specific symptom profile, 2) specific cofactors, and 3) specific management. Identifying the differences in phenotypes of anaphylaxis is crucial for future management guidelines and development of a personalized medicine approach.

Objective: This study aimed to evaluate the phenotype and risk factors of VIA.

Methods: Using data from the European Anaphylaxis Registry (12,874 cases), we identified 3,612 patients with VIA and analyzed their cases in comparison with sex- and age-matched anaphylaxis cases triggered by other elicitors (non-VIA cases [n = 3,605]).

Results: VIA more frequently involved more than 3 organ systems and was associated with cardiovascular symptoms. The absence of skin symptoms during anaphylaxis was correlated with baseline serum tryptase level and was associated with an increased risk of a severe reaction. Intramuscular or intravenous epinephrine was administered significantly less often in VIA, in particular, in patients without a history of anaphylaxis. A baseline serum tryptase level within the upper normal range (8-11.5 ng/mL) was more frequently associated with severe anaphylaxis.

Conclusion: Using a large cohort of VIA cases, we have validated that patients with intermediate baseline serum tryptase levels (8-11 ng/mL) and without skin involvement have a higher risk of severe VIA. Patients receiving beta-blockers or angiotensin-converting enzyme inhibitors had a higher risk of developing severe cardiovascular symptoms (including cardiac arrest) in VIA and non-VIA cases. Patients experiencing VIA received epinephrine less frequently than did cases with non-VIA.

Harvard Citation style: Francuzik, W., Rueeff, F., Bauer, A., Bilo, M., Cardona, V., Christoff, G., et al. (2021) Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry, Journal of Allergy and Clinical Immunology, 147(2), pp. 653-65+. https://doi.org/10.1016/j.jaci.2020.06.008

APA Citation style: Francuzik, W., Rueeff, F., Bauer, A., Bilo, M., Cardona, V., Christoff, G., Doelle-Bierke, S., Ensina, L., Rivas, M., Hawranek, T., Hourihane, J., Jakob, T., Papadopoulos, N., Pfoehler, C., Poziomkowska-Gesicka, I., Van der Brempt, X., Hofmeier, K., Treudler, R., Wagner, N., ...Worm, M. (2021). Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry. Journal of Allergy and Clinical Immunology. 147(2), 653-65+. https://doi.org/10.1016/j.jaci.2020.06.008