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Fatal Anaphylaxis (fatal + anaphylaxis)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Food allergy in adolescents and adults

INTERNAL MEDICINE JOURNAL, Issue 7 2009
J. Yun
Abstract There has been an increase in the prevalence of food allergy in the last few decades. Adult food allergy may represent persistence of reactions that commenced in infancy and early childhood or it may be initiated in adulthood through new sensitizations. Persistence of peanut allergy is an example of the former situation. Approximately 20% of children will develop tolerance to peanuts, so there will be an increasing number of individuals reaching adulthood where this problem will need ongoing management. In addition to peanut, tree nuts, fruits, vegetables and seafood are implicated as common causes of food allergy in adulthood. Sensitization may occur directly to a food allergen or indirectly through cross-reactivity with an aeroallergen. Adults may present with a spectrum of clinical manifestations from oral allergy syndrome to fatal anaphylaxis. The management of food allergy consists of appropriate education regarding avoidance of implicated foods, modifying potential risk factors for anaphylaxis, such as asthma and prompt recognition and treatment of acute reactions. [source]

A case of fatal anaphylaxis in a dog associated with a dexamethasone suppression test

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2005
DACVECC, DACVIM, Michael Schaer DVM
Abstract Objective: To describe a case of fatal anaphylaxis in a dog associated with a ,routine' dexamethasone suppression test. Case summary: An 8-year-old, spayed female dog, was treated with parenteral dexamethasone for a diagnosis of immune-mediated thrombocytopenia. The dog had responded to treatment, but 9 months later was evaluated for endogenous hyperadrenocorticism, prior to surgery for a ruptured anterior cruciate ligament. A normal ACTH stimulation test was followed by a high-dose dexamethasone suppression test. Immediately following the intravenous injection of dexamethasone, the dog developed severe anaphylactic shock and died. The postmortem examination findings supported the diagnosis of anaphylaxis. New information provided: The anaphylaxis in this dog was fulminating and by-passed the usual early signs of drug hypersensitivity. This is the first case in the veterinary literature reporting on dexamethasone as the cause of this dog's catastrophic event. [source]

Lessons for management of anaphylaxis from a study of fatal reactions

CLINICAL & EXPERIMENTAL ALLERGY, Issue 8 2000
Pumphrey
Background The unpredictability of anaphylactic reactions and the need for immediate, often improvised treatment will make controlled trials impracticable; other means must therefore be used to determine optimal management. Objectives This study aimed to investigate the circumstances leading to fatal anaphylaxis. Methods A register was established including all fatal anaphylactic reactions in the UK since 1992 that could be traced from the certified cause of death. Data obtained from other sources suggested that deaths certified as due to anaphylaxis underestimate the true incidence. Details of the previous medical history, the reaction and necropsy were sought for all cases. Results Approximately half the 20 fatal reactions recorded each year in the UK were iatrogenic, and a quarter each due to food or insect venom. All fatal reactions thought to have been due to food caused difficulty breathing that in 86% led to respiratory arrest; shock was more common in iatrogenic and venom reactions. The median time to respiratory or cardiac arrest was 30 min for foods, 15 min for venom and 5 min for iatrogenic reactions. Twenty-eight per cent of fatal cases were resuscitated but died 3 h,30 days later, mostly from hypoxic brain damage. Adrenaline (epinephrine) was used in treatment of 62% of fatal reactions but before arrest in only 14%. Conclusions Immediate recognition of anaphylaxis, early use of adrenaline, inhaled beta agonists and other measures are crucial for successful treatment. Nevertheless, a few reactions will be fatal whatever treatment is given; optimal management of anaphylaxis is therefore avoidance of the cause whenever this is possible. Predictable cross-reactivity between the cause of the fatal reaction and that of previous reactions had been overlooked. Adrenaline overdose caused at least three deaths and must be avoided. Kit for self-treatment had proved unhelpful for a variety of reasons; its success depends on selection of appropriate medication, ease of use and good training. [source]