Portal de Periódicos da CAPES

Artigo Produção Nacional Revisado por pares

BIBTEX RIS

Risk Factors and Characteristics of Biphasic Anaphylaxis

2020; Elsevier BV; Volume: 8; Issue: 10 Linguagem: Inglês

10.1016/j.jaip.2020.07.036

2213-2201

Magdalena Kraft, Kathrin Scherer, Franziska Ruëff, Claudia Pföhler, Jean‐Marie Renaudin, Maria Beatrice Bilò, Regina Treudler, Roland Lang, Ewa Cichocka‐Jarosz, Montserrat Fernández‐Rivas, George Christoff, Nikolaos G. Papadopoulos, Luís Felipe Ensina, Jonathan O’B Hourihane, Ioana Maris, Alice Koehli, Blanca E. García, Uta Jappe, Christian Vogelberg, Hagen Ott, Lars Lange, Thomas Spindler, Sabine Dölle, Margitta Worm,

Allergic Rhinitis and Sensitization

Anaphylaxis is an immediate hypersensitivity reaction. However, a biphasic course with the second onset of symptoms can occur hours after the initial phase. Little is known about the causes of biphasic anaphylaxis making the identification of patients at risk difficult.To identify factors predisposing for biphasic anaphylaxis for the better understanding of these reactions.Data from the Anaphylaxis Registry (from 11 countries) including 8736 patients with monophasic and 435 biphasic anaphylaxis were analyzed.The rate of biphasic reactions in this large cohort was 4.7%. The identified risk factors were reaction severity (grade III/IV vs grade II: odds ratio [OR] = 1.34; 95% confidence interval [CI]: 1.1-1.62); multiorgan involvement; skin, gastrointestinal, severe respiratory, and cardiac symptoms; anaphylaxis caused by peanut/tree nut (OR = 1.78; 95% CI: 1.38-2.23) or an unknown elicitor (OR = 1.96; 95% CI: 1.41-2.72); exercise as a cofactor (OR = 1.44; 95% CI: 1.17-1.78); chronic urticaria as a comorbidity (OR = 2.12; 95% CI: 1.19-3.78); a prolonged interval between the contact with the elicitor and start of primary symptoms (OR for >30 vs <30 min: 1.38; 95% CI: 1.08-1.76); and antihistamine treatment (OR = 1.52; 95% CI: 1.14-2.02).A biphasic course of anaphylaxis occurs more frequently in severely affected patients with multiorgan involvement. However, we identified multiple additional predictors, suggesting that the pathogenesis of biphasic reactions is more complex than being a rebound of a severe primary reaction.