ANAPHYLAXIS is a severe, life-threatening allergic reaction commonly triggered by food, drugs, or venom. Despite its clinical significance, limited research has explored variations in symptoms and management across different anaphylaxis triggers. This study aimed to assess sociodemographic characteristics, clinical presentations, and treatment patterns in adult patients experiencing anaphylaxis due to various triggers.
This cross-sectional study included 1,135 adults presenting with anaphylaxis to eight Canadian emergency departments and one electronic medical service between April 2011 and November 2023. The median age of participants was 35.5 years (interquartile range 25.3–51.1), and 50.3% presented with food-induced anaphylaxis (FIA). Multivariate regression models evaluated symptoms and treatments associated with specific triggers, including drug-induced (DIA), venom-induced (VIA), peanut-induced (PIA), shellfish-induced, tree-nut-induced (TIA), and other nut-induced anaphylaxis (NIA).
Key findings included a strong association between DIA and hypotension (adjusted odds ratio [aOR] = 1.20; 95% confidence interval [CI] ,1.11–1.30; p < 0.01). Alcohol consumption was more likely linked to NIA (aOR = 1.51; 95% CI, 1.04–2.19; p = 0.035). Regarding treatment, TIA was strongly associated with inpatient epinephrine administration (aOR = 2.05; 95% CI, 1.16–3.64; p = 0.014), while outpatient antihistamine use was less common for DIA (aOR = 0.68; 95% CI, 0.48–0.89; p < 0.01) but more frequent for TIA (aOR = 1.81; 95% CI, 1.03–3.19; p = 0.040).
These findings highlight the importance of recognising trigger-specific patterns in anaphylaxis to enhance clinical care. For example, VIA was associated with hypotension, and TIA with throat tightness, offering diagnostic clues in emergency departments. Incorporating such insights into clinical practice can enable faster diagnosis and more tailored interventions, improving patient outcomes. Future studies should explore these associations across diverse populations and refine management guidelines to reflect trigger-specific needs.
Abigail Craig, EMJ
Reference
Khalaf R et al. Symptomatology and Management of Adult Anaphylaxis according to Trigger: A Cross-Sectional Study. Int Arch Allergy Immunol. 2024. DOI: 10.1159/000542115.