Anaphylaxis: few patients with idiopathic episodes had recurrences when on therapy

Clinical bottom line (level 4)

  1. Few patients with idiopathic anaphylaxis on treatment were readmitted to hospital with anaphylaxis.
Wiggins et al: Journal of Allergy and Clinical Immunology 1988; 82 (5): 849-855
Expires November 2004

The study

Case series with unblinded, unobjective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: allergy clinic, university hospital, USA

123 patients (aged 7 to 79, 69% female) referred with one or more episodes of anaphylaxis of unknown cause
Patients were given injectable epinephrine for further attacks, and patients with frequent life-threatening episodes were treated with steroids.

76% followed for 5 months to 5 years
Outcomes studied:
  • readmission to hospital with idiopathic anaphylaxis

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    readmission to hospital with idiopathic anaphylaxis 5 months to 5 years 2/123 1.6%
    (0.0% to 3.9%)

    Comments

    1. 42% of patients had more than 6 episodes a year (95% CI: 33% to 50%)
    2. Common symptoms included upper airway obstruction (58%), bronchospasm (33%), hypotension (31%), collapse (24%), GI symptoms (20%) and flushing (14%).

    Citation

    1. Wiggins CA, Dykewicz MS, Patterson R: idiopathic anaphylaxis: classification, evaluation and treatment of 123 patients. Journal of Allergy and Clinical Immunology 1988; 82 (5): 849-855
    Contributor: Mike Bennett and Chris Ball, November 1999
    Reviewer: Chris Ball

    Clinical Question.
    Patient idiopathic anaphylaxis
    Intervention or Exposure therapy
    Outcome readmission with anaphylaxis