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Global Trends in Anaphylaxis Epidemiology and Clinical Implications

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...

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Detalles Bibliográficos
Autores principales: Turner, Paul J., Campbell, Dianne E., Motosue, Megan S., Campbell, Ronna L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152797/
https://www.ncbi.nlm.nih.gov/pubmed/31786255
http://dx.doi.org/10.1016/j.jaip.2019.11.027
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author Turner, Paul J.
Campbell, Dianne E.
Motosue, Megan S.
Campbell, Ronna L.
author_facet Turner, Paul J.
Campbell, Dianne E.
Motosue, Megan S.
Campbell, Ronna L.
author_sort Turner, Paul J.
collection PubMed
description 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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spelling pubmed-71527972020-04-17 Global Trends in Anaphylaxis Epidemiology and Clinical Implications Turner, Paul J. Campbell, Dianne E. Motosue, Megan S. Campbell, Ronna L. J Allergy Clin Immunol Pract Article 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. Elsevier Inc 2020-04 /pmc/articles/PMC7152797/ /pubmed/31786255 http://dx.doi.org/10.1016/j.jaip.2019.11.027 Text en © 2019 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Turner, Paul J.
Campbell, Dianne E.
Motosue, Megan S.
Campbell, Ronna L.
Global Trends in Anaphylaxis Epidemiology and Clinical Implications
title Global Trends in Anaphylaxis Epidemiology and Clinical Implications
title_full Global Trends in Anaphylaxis Epidemiology and Clinical Implications
title_fullStr Global Trends in Anaphylaxis Epidemiology and Clinical Implications
title_full_unstemmed Global Trends in Anaphylaxis Epidemiology and Clinical Implications
title_short Global Trends in Anaphylaxis Epidemiology and Clinical Implications
title_sort global trends in anaphylaxis epidemiology and clinical implications
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152797/
https://www.ncbi.nlm.nih.gov/pubmed/31786255
http://dx.doi.org/10.1016/j.jaip.2019.11.027
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