Anaphylaxis: common causes of fatal reactions include venom, anaesthetics and nuts

Clinical bottom line (level 2c)

  1. Common causes of fatal anaphylactic reactions were venom, anaesthetics, nuts and antibiotics.
Pumphrey : Clinical and Experimental Allergy 2000; 30: 1144-1150
Expires November 2004

The study

Setting: UK

139 patients (aged 5 to 88, 53% male) people who died from an anaphylactic reaction, 1992 - 1998

The evidence


differential diagnosis number of patients prevalence
(95% CI)
venom 35 25%
(18% to 32%)
anaesthetic 27 19%
(13% to 26%)
nuts 25 18%
(12% to 24%)
antibiotic 16 12%
(6% to 17%)
other food 14 10%
(5% to 15%)
other iatrogenic 13 9%
(5% to 14%)
contrast 8 6%
(2% to 10%)

Comments

  1. Data was collected from death certificates, coroners and medical staff involved in the case.
  2. Median time to respiratory or cardiac arrest was 30 min for foods, 15 min for venom and 5 min for iatrogenic reactions.
  3. 28% were resuscitated but died 3 hours to 30 days later mostly from hypoxic brain damage.

Citation

  1. Pumphrey RS, : lessons for mangement of anaphylaxis from a study of fatal reactions. Clinical and Experimental Allergy 2000; 30: 1144-1150
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Contributor: Chris Ball, November 2001
Reviewer:

Clinical Question.
Patient anaphylaxis
Intervention or Exposure death
Outcome cause