In 1981 generalized
anaphylaxis was registered on 166 occasions in Dutch general and academic hospitals. Clinical details of 120 of those patients revealed that in 107
anaphylaxis was either probable (n = 90) or possible (n = 17), whereas in 13 cases some other reaction than
anaphylaxis had occurred. The series of confirmed cases contained 46 men and 61 women, with mean ages of 47 y and 48 y, respectively. There was a complete recovery in 102 patients and two patients died.
Hypotension was present in 79 cases (74%), dyspnoea in 34 cases (32%) and a skin reaction, mainly
urticaria,
erythema or
angioedema, was mentioned in 62 cases (58%). Most cases of
anaphylaxis were
drug-induced (76%), the main causes being the
analgesic glafenine and
contrast media.
Glafenine was mentioned as the cause in 36% of all admissions for
drug-induced
anaphylaxis. Only 3.7% of cases had been reported to the voluntary reporting scheme of the Netherlands Centre for Monitoring of Adverse Reactions to Drugs. On the basis of reimbursement data, the risk of developing severe
anaphylaxis to
glafenine was estimated at 11.7-19.3-fold relative to
indomethacin, and 13.4-20.2-fold relative to oral
penicillins.