SELECTED ARTICLES FROM THE RECENT LITERATURE 2006

12/15/06

Anaphylaxis case review

Summary
Background – There are still numerous uncertainties about the etiology, diagnosis and treatment of anaphylactic (Anaph) reactions.

Findings – Webb and Lieberman reviewed characteristics of 601 patients with Anaph reactions seen in their office practice connected with the Univ of Tennessee over a 25 year period. These reactions were more common in females (62%), occurred with a mean age 37 years, with a cause elucidated in 41% of cases (foods in 22%, medication in 11%, exercise in 5%, systemic mastocytosis in 3%). Atopy was present in 37% of the patients..

The most common manifestations were urticaria/angioedema (87% of cases). Episodes tended to decrease in frequency over a period of time.

Although self-injected epinephrine has subsequently been carried more commonly by at-risk individuals after initial evaluation in recent years, adherence to correct use of self-injected epinephrine bears improvement. Such correct use can be enhanced by more effective teaching by health care providers.

Reference
Ann Allergy Asthma Immunol 2006;97:39-43

Editor's Comments
The pragmatic approach to Anaph by a very experienced group described in this report is well worth reading. The differential diagnosis of Anaph is often difficult in atypical cases. Many patients need “refresher” teaching about the correct self-administration of epinephrine injections.

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