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SELECTED ARTICLES FROM THE RECENT LITERATURE 2007
December 19, 2007
A Significant Number of Food-Induced Anaphylactic Episodes Presenting to the Emergency Room Require Two Doses of Epinephrine
Summary
This was an investigation that was performed as an extension of an earlier study of anaphylaxis to foods presenting to emergency rooms. It consisted of a review of 39 medical records of patients with food-induced anaphylaxis presenting to the Massachusetts General Hospital Emergency Department during a one-year period.
Of 39 patients evaluated, 34 had an acute food-induced allergic reaction, and 19 of these had anaphylaxis. Because of the small number, statistical analysis was not possible. However, it was observed that 3 of the patients with anaphylaxis received one or two doses of epinephrine. The authors concluded from these data that 16% of patients with food-induced anaphylaxis require two doses of epinephrine.
Editor's Comments
These data are similar to those obtained via previous studies which have shown that a minimum of 16% of anaphylactic episodes necessitate the administration of two doses of epinephrine. The study does not address whether these patients had biphasic anaphylaxis or simply required two doses because of the severity of the event. It is consistent with data finding a range of anaphylactic episodes from 16 to 36% need two injections to obtain control of the event.
Reference
Oren E, et al. Food-induced anaphylaxis and repeated epinephrine injections. Annals of Allergy, Asthma, and Immunology 2007; 99:429-432.
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