Biphasic reactions in patients with anaphylaxis treated with corticosteroids.

Abstract

BACKGROUND:

Although the incidence of anaphylaxis is rapidly increasing, the clinical characteristics and associated factors of a biphasic reaction are unclear.

OBJECTIVE:

To determine the incidence and clinical characteristics of biphasic reactions in patients with anaphylaxis treated with corticosteroids.

METHODS:

A total of 655 patients with anaphylaxis visiting the emergency department of a tertiary teaching hospital from January 2007 through December 2014 were analyzed. Patient characteristics, triggers, symptoms and signs, in-hospital management, and disposition were recorded. A biphasic reaction was defined as the development of anaphylaxis after complete resolution of the initial reaction without further exposure to the offending agent within 7 days. Univariate and multivariate analyses on the predictors of the biphasic reaction were performed.

RESULTS:

Of the 415 patients with anaphylaxis treated with corticosteroids, 9 patients (2.2%) developed a biphasic reaction. The mean age was 48.4 years, and 221 patients (54.4%) were women. The median time from complete resolution of initial clinical symptoms to occurrence of the biphasic reaction was 15 hours (range 1-45). History of drug anaphylaxis (odds ratio 14.3, 95% confidence interval 2.4-85.8) was a contributing factor to the development of the biphasic reaction.

CONCLUSION:

The incidence of biphasic reactions was 2.2% in patients treated with corticosteroids and those with a history of drug anaphylaxis were at greater risk.

• Authors: Byuk Sung Ko, Won Young Kim, Seung Mok Ryoo, Shin Ahn, Chang Hwan Sohn, Dong-Woo Seo, Yoon-Seon Lee, Kyoung Soo Lim, Tae-Bum Kim
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 115 Issue 4 Pg. 312-6 (Oct 2015) ISSN: 1534-4436 [Electronic] United States
• PMID: 26276313 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Adrenal Cortex Hormones
• Epinephrine

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Anaphylaxis (drug therapy, epidemiology)
• Cohort Studies
• Drug Hypersensitivity (physiopathology)
• Emergency Service, Hospital (statistics & numerical data)
• Epinephrine (therapeutic use)
• Female
• Food Hypersensitivity (physiopathology)
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Risk Factors
• Time Factors