Risk Factors in Severe Anaphylaxis: Which Matters The Most, Food or Cofactors?

BACKGROUND AND OBJECTIVE: The prevalence of anaphylactic shock, the most severe manifestation of anaphylaxis, remains unknown. Risk factors and biomarkers have not been fully identified. Objective: To identify risk factors in anaphylactic shock patients. METHODS: Using lipid transfer protein (LTP)al...

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Detalles Bibliográficos
Autores: Casas-Saucedo, R, de la Cruz, C, Araujo-Sanchez, G, Gelis, S, Jimenez, T, Riggioni, S, San Bartolome, C, Pascal, M, Bartra Tomas, J, Munoz-Cano, R
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p7285
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones7285
http://www.jiaci.org/ahead-of-print/risk-factors-in-severe-anaphylaxis--which-matters-the-most--food-or-cofactors-
Access Level:acceso abierto
Palabra clave:Anaphylactic shock
Anaphylaxis
Cofactor
Food allergy
Descripción
Sumario:BACKGROUND AND OBJECTIVE: The prevalence of anaphylactic shock, the most severe manifestation of anaphylaxis, remains unknown. Risk factors and biomarkers have not been fully identified. Objective: To identify risk factors in anaphylactic shock patients. METHODS: Using lipid transfer protein (LTP)allergy as a model, the characteristics of patients who developed anaphylaxis and anaphylactic shock were compared. Demographics, pollen sensitization, foods ingested up to 2 hours before the reaction onset, and the presence of a cofactor were recorded. Culprit foods were identified by compatible clinical history and positive allergological work-up (skin prick test and/or sIgE). RESULTS: 150 reactions were evaluated, suffered by 55 patients with An (134 reactions) and 12 with AnS (16 reactions). Patients in the anaphylaxis group experienced twice as many reactions (mean [SD] 2.4[2.5] in An vs 1.3[1.5) in AnS, p<0.02). No relationship between any food group and reaction severity was found. The most frequent food involved in both groups of patients was the combination of several plant-derived foods ("plant food mix"), followed by peach and nuts. Indeed, in the "plant food mix" reactions the presence of a cofactor was more often observed than in other food groups. On the other hand, cofactors were not present in peach- and nuts-related reactions. Exercise was the most frequent cofactor in all groups. CONCLUSION: In our series, the severity of the reactions was not determined by the kind of food or presence of a cofactor. Anaphylactic shock seems an infrequent presentation that may be related with other individual-related factors that need further evaluation.