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E Faria,1 J
Rodrigues-Cernadas,2 Â Gaspar,3 C
Botelho,2 E Castro,2 A Lopes,4
E Gomes,5 D Malheiro,6 S Cadinha,6
S
Campina-Costa,7 M Neto,8 N
Sousa,1 R Rodrigues-Alves,9 A
Romeira,10 J Caiado,4 M
Morais-Almeida,3 Portuguese Society of
Allergology and Clinical Immunology (SPAIC) Drug Allergy
Interest Group |
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1Immunoallergology
Department, Hospital Universidade de Coimbra, Centro
Hospital e Universitário de Coimbra, Coimbra, Portugal
2Immunoallergology Department, Centro
Hospitalar São João, Porto, Portugal
3Immunoallergology Department, Hospital CUF
Descobertas, Lisboa, Portugal
4Immunoallergology Department, Hospital de
Santa Maria, Centro Hospitalar Lisboa Norte, Portugal
5Immunoallergology Department, Hospital Maria
Pia, Centro Hospitalar do Porto, Portugal
6Immunoallergology Department, Centro
Hospitalar de Vila Nova de Gaia/Espinho, Portugal
7Immunoallergology Department, Hospital de
Egas Moniz, Centro Hospitalar Lisboa Ocidental, Portugal
8Immunoallergology Department, Hospital
Pulido Valente, Centro Hospitalar Lisboa Norte, Portugal
9Immunoallergology Department, Hospital
Divino Espírito Santo, Ponta Delgada, Açores, Portugal
10Immunoallergology Department, Hospital de
Dona Estefânia, Centro Hospitalar Lisboa Central,
Portugal |
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Abstract |
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Background and
Objective:
Drug-induced
anaphylaxis is an
unpredictable and
potentially fatal
adverse drug
reaction. The aim of
this study was to
identify the causes
of drug-induced
anaphylaxis in
Portugal.
Methods:
During a 4-year
period a nationwide
notification system
for anaphylaxis was
implemented, with
voluntary reporting
by allergists. Data
on 313 patients with
drug anaphylaxis
were received and
reviewed.
Statistical analysis
included
distribution tests
and multiple
logistic regression
analysis to
investigate
significance,
regression
coefficients, and
marginal effects.
Results: The
mean (SD) age of the
patients was 43.8
(17.4) years, and
8.3% were younger
than 18 years. The
female to male ratio
was 2:1. The main
culprits were
nonsteroidal
anti-inflammatory
drugs (NSAIDs)
(47.9% of cases),
antibiotics (35.5%),
and anesthetic
agents (6.1%). There
was a predominance
of mucocutaneous
symptoms (92.2%),
followed by
respiratory symptoms
(80.4%) and
cardiovascular
symptoms (49.0%).
Patients with NSAID-induced
anaphylaxis showed a
tendency towards
respiratory and
mucocutaneous
manifestations. We
found no significant
associations between
age, sex, or atopy
and type of drug.
Anaphylaxis
recurrence was
observed in 25.6% of
cases, and the risk
was higher when
NSAIDs were
involved.
Conclusions:
NSAIDs were the most
common cause of
anaphylaxis in this
study and were also
associated with a
higher rate of
recurrence. We
stress the need for
better therapeutic
management and
prevention of
recurring episodes
of drug-induced
anaphylaxis.
Key words:
Anaphylaxis. Drug
hypersensitivity.
Notification.
Portuguese survey. |
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