Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry

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dc.contributor.author Francuzik, Wojciech
dc.contributor.author Ruëff, Franziska
dc.contributor.author Bauer, Andrea
dc.contributor.author Bilò, Maria Beatrice
dc.contributor.author Cardona, Victoria
dc.contributor.author Christoff, George
dc.contributor.author Dölle-Bierke, Sabine
dc.contributor.author Ensina, Luis
dc.contributor.author Fernández Rivas, Montserrat
dc.contributor.author Hawranek, Thomas
dc.contributor.author Hourihane, Jonathan O'B.
dc.contributor.author Jakob, Thilo
dc.contributor.author Papadopoulos, Nicos G.
dc.contributor.author Pföhler, Claudia
dc.contributor.author Poziomkowska-Gesicka, Iwona
dc.contributor.author Van der Brempt, Xavier
dc.contributor.author Scherer Hofmeier, Kathrin
dc.contributor.author Treudler, Regina
dc.contributor.author Wagner, Nicola
dc.contributor.author Wedi, Bettina
dc.contributor.author Worm, Margitta
dc.date.accessioned 2020-09-10T09:22:36Z
dc.date.available 2020-09-10T09:22:36Z
dc.date.issued 2020-06-22
dc.identifier.citation Francuzik, W., Ruëff, F., Bauer, A., Bilò, M. B., Cardona, V., Christoff, G., Dölle-Bierke, S., Ensina, L., Rivas, M. F., Hawranek, T., Hourihane, J. O. B., Papadopoulos, G., Pföhler, C., Poziomkowska-Gęsicka, I., Van der Brempt, X., Scherer Hofmeier, K., Treudler, R., Wagner, N., Wedi, B. and Worm, M. (2020) ‘Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry’, Journal of Allergy and Clinical Immunology. doi: 10.1016/j.jaci.2020.06.008 en
dc.identifier.issn 0091-6749
dc.identifier.uri http://hdl.handle.net/10468/10500
dc.identifier.doi 10.1016/j.jaci.2020.06.008 en
dc.description.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 β-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. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier B.V. en
dc.rights © 2020, American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license. en
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/ en
dc.subject Anaphylaxis en
dc.subject Epinephrine (adrenaline) en
dc.subject Hymenoptera en
dc.subject Insect venom allergy en
dc.subject β-blockers en
dc.title Phenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registry en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Jonathan Hourihane, Paediatrics & Child Health, University College Cork, Cork, Ireland. +353-21-490-3000 en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2021-06-22
dc.date.updated 2020-09-10T08:35:54Z
dc.description.version Accepted Version en
dc.internal.rssid 530790960
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal of Allergy and Clinical Immunology en
dc.internal.copyrightchecked Yes
dc.internal.licenseacceptance Yes en
dc.internal.bibliocheck In press. Check vol / issue / page range. Amend citation as necessary. en


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© 2020, American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license. Except where otherwise noted, this item's license is described as © 2020, American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license.
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