Allergen immunotherapy-induced anaphylaxis

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology Pub Date : 2025-06-01 DOI:10.1016/j.anai.2025.02.012

Meslina Almaci MD , Regina Treudler MD , Maria Breiding MD , Alice Köhli MD , Lars Lange MD , Claudia Pföhler MD , Christian Vogelberg MD , Margitta Worm MD

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引用次数: 0

Abstract

Background

Data on anaphylaxis due to allergen immunotherapy (AIT) are limited. This study assessed AIT-induced anaphylaxis using data from the European Anaphylaxis Registry.

Objective

To analyze the characteristics, symptoms, severity, and emergency management of AIT-induced anaphylactic reactions across age groups and the administered allergenic source.

Methods

Data were obtained from 54 allergy centers across 10 European countries from 2007 to 2023. Anaphylactic reactions involving at least 2 organ systems were analyzed for symptoms, severity, associated diseases, administration routes, and emergency treatment. Statistical methods included χ² and Fisher's exact tests.

Results

AIT accounted for 1.1% of the cases in the anaphylaxis registry (173/15,748), of which 1.8% were pediatric and 0.7% were adults. Respiratory symptoms were more frequent in children/adolescents (92%) than in adults (66%) among AIT-related anaphylaxis, whereas cardiovascular and gastrointestinal symptoms were more common in adults (40% vs 78% and 20% vs 42%, respectively). Only a few sublingual immunotherapy-related cases were documented, including 2 grade III reactions, with no fatalities (sublingual immunotherapy [n = 8] vs subcutaneous immunotherapy (SCIT) [n = 153]). One fatality due to SCIT was reported (grass pollen). Delayed reactions (>30 minutes) were reported in 22 cases, predominantly after SCIT. All delayed grade III reactions that occurred more than 120 minutes were reported in children. Adrenaline was underused in emergency management and administered in 30% of grade II and 50% of grade III reactions.

Conclusion

Our study highlights the importance of age-specific monitoring and appropriate emergency treatment to enhance patient safety during AIT.

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过敏原免疫疗法诱发的过敏性休克--来自欧洲过敏性休克登记处的数据。

背景：有关过敏原免疫疗法（AIT）引起过敏性休克的数据十分有限。本研究利用欧洲过敏性休克登记处的数据对 AIT 引起的过敏性休克进行了评估：目的：分析不同年龄组和给药过敏源的 AIT 引起的过敏性反应的特征、症状、严重程度和紧急处理方法：方法：2007 年至 2023 年期间，10 个欧洲国家的 54 个过敏中心为本分析提供了数据。分析了至少涉及两个器官系统的过敏反应的症状、严重程度、相关疾病、给药途径和紧急治疗。统计方法包括卡方检验和费雪精确检验：在过敏性休克登记中，AIT占1.1%（173/15,748），其中1.8%为儿童，0.7%为成人。在与 AIT 相关的过敏性休克病例中，呼吸道症状在儿童/青少年中的发生率（92%）高于成人（66%），而心血管和胃肠道症状在成人中的发生率更高（40% 对 78% 和 20% 对 42%）。与 SLIT 相关的病例仅有少数记录在案，其中包括 2 例 III 级反应，无死亡病例（SLIT n=8 vs. SCIT n=153）。有报告称，SCIT 导致 1 例死亡（草花粉）。有 22 例报告了延迟反应（>30 分钟），主要发生在 SCIT 之后。所有超过 120 分钟的 III 级延迟反应均发生在儿童身上。肾上腺素在应急处理中使用不足，30%的二级反应和50%的三级反应都使用了肾上腺素：我们的研究强调了针对不同年龄段的监测和适当的应急处理对提高 AIT 期间患者安全的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Allergy Asthma & Immunology 医学-过敏

CiteScore

6.50

自引率

6.80%

发文量

437

审稿时长

33 days

期刊介绍： Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.