Anaphylaxis: incidence, presentation, causes and outcome in patients in a tertiary-care hospital in Karachi, Pakistan.

Publication Type Academic Article
Authors Khan N, Shakeel N, Makda A, Mallick A, Ali Memon M, Hashmi S, Khan U, Razzak J
Journal QJM
Volume 106
Issue 12
Pagination 1095-101
Date Published 09/30/2013
ISSN 1460-2393
Keywords Anaphylaxis
Abstract BACKGROUND: Anaphylaxis is a potentially fatal condition requiring immediate resuscitation. Data regarding the epidemiology of anaphylaxis are limited and inconsistent. A reason for the variability was unavailability of a universally acceptable case definition till 2005. We reviewed cases using this new definition AIM: To review the incidence, clinical presentation, cause and outcome of anaphylaxis at a tertiary-care centre in a low-income country. DESIGN: Retrospective, case series METHODS: Chart review of all patients discharged from Aga Khan University Hospital between January 1988 and December 2012 (24 years) with anaphylaxis definition as per second National Institute of Allergy and Infection disease/Food Allergy and Anaphylaxis Network Symposium RESULTS: Total of 129 cases were found with mean age of 41.6 years (SD 18.8). Majority of patients had cutaneous features (76.7%), followed by respiratory (68.9%), cardiac (64.3%) and gastrointestinal (20.9%) symptoms, respectively. About 22.4% of patients had positive history for allergens out of which 31% (n = 9) were exposed to the same allergens. The common causes identified for anaphylaxis were drugs (60.5%), food (16.3%) and intravenous contrast (10.9%), respectively. Only 22.5% of cases received epinephrine as a part of their initial management. In four patients (3.1%) the cause of death was attributed to anaphylaxis. CONCLUSION: Anaphylaxis is a rare but life-threatening condition. Though cutaneous features are most common, their absence does not exclude the diagnosis. Drugs were the most common cause and epinephrine was not commonly used as first-line agent for its management.
DOI 10.1093/qjmed/hct179
PubMed ID 24082151
PubMed Central ID PMC3840329
Back to Top