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

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dc.check.date2021-06-22
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorFrancuzik, Wojciech
dc.contributor.authorRuëff, Franziska
dc.contributor.authorBauer, Andrea
dc.contributor.authorBilò, Maria Beatrice
dc.contributor.authorCardona, Victoria
dc.contributor.authorChristoff, George
dc.contributor.authorDölle-Bierke, Sabine
dc.contributor.authorEnsina, Luis
dc.contributor.authorFernández Rivas, Montserrat
dc.contributor.authorHawranek, Thomas
dc.contributor.authorHourihane, Jonathan O'B.
dc.contributor.authorJakob, Thilo
dc.contributor.authorPapadopoulos, Nicos G.
dc.contributor.authorPföhler, Claudia
dc.contributor.authorPoziomkowska-Gesicka, Iwona
dc.contributor.authorVan der Brempt, Xavier
dc.contributor.authorScherer Hofmeier, Kathrin
dc.contributor.authorTreudler, Regina
dc.contributor.authorWagner, Nicola
dc.contributor.authorWedi, Bettina
dc.contributor.authorWorm, Margitta
dc.date.accessioned2020-09-10T09:22:36Z
dc.date.available2020-09-10T09:22:36Z
dc.date.issued2020-06-22
dc.date.updated2020-09-10T08:35:54Z
dc.description.abstractBackground: 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.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationFrancuzik, 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.2020.06.008en
dc.identifier.doi10.1016/j.jaci.2020.06.008en
dc.identifier.issn0091-6749
dc.identifier.journaltitleJournal of Allergy and Clinical Immunologyen
dc.identifier.urihttps://hdl.handle.net/10468/10500
dc.language.isoenen
dc.publisherElsevier 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.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectAnaphylaxisen
dc.subjectEpinephrine (adrenaline)en
dc.subjectHymenopteraen
dc.subjectInsect venom allergyen
dc.subjectβ-blockersen
dc.titlePhenotype and risk factors of venom-induced anaphylaxis: A case-control study of the European Anaphylaxis Registryen
dc.typeArticle (peer-reviewed)en
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