Anaphylaxis in Elderly Patients—Data From the European Anaphylaxis Registry
Background: Elicitors and symptoms of anaphylaxis are age dependent. However, little is known about typical features of anaphylaxis in patients aged 65 years or more.Methods: The data from the Network for Online Registration of Anaphylaxis (NORA) considering patients aged ≥65 (elderly) in comparison...
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Format: | Article |
Language: | English |
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Frontiers Media S.A.
2019-04-01
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Series: | Frontiers in Immunology |
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Online Access: | https://www.frontiersin.org/article/10.3389/fimmu.2019.00750/full |
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doaj-7c5da283473048ffaa86c888bb8d3243 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stefanie Aurich Sabine Dölle-Bierke Wojciech Francuzik Maria Beatrice Bilo George Christoff George Christoff Montserrat Fernandez-Rivas Thomas Hawranek Claudia Pföhler Iwona Poziomkowska-Gȩsicka Jean-Marie Renaudin Eva Oppel Kathrin Scherer Regina Treudler Margitta Worm |
spellingShingle |
Stefanie Aurich Sabine Dölle-Bierke Wojciech Francuzik Maria Beatrice Bilo George Christoff George Christoff Montserrat Fernandez-Rivas Thomas Hawranek Claudia Pföhler Iwona Poziomkowska-Gȩsicka Jean-Marie Renaudin Eva Oppel Kathrin Scherer Regina Treudler Margitta Worm Anaphylaxis in Elderly Patients—Data From the European Anaphylaxis Registry Frontiers in Immunology anaphylaxis elderly insect venom drug hypersensitivity adrenaline hospitalization |
author_facet |
Stefanie Aurich Sabine Dölle-Bierke Wojciech Francuzik Maria Beatrice Bilo George Christoff George Christoff Montserrat Fernandez-Rivas Thomas Hawranek Claudia Pföhler Iwona Poziomkowska-Gȩsicka Jean-Marie Renaudin Eva Oppel Kathrin Scherer Regina Treudler Margitta Worm |
author_sort |
Stefanie Aurich |
title |
Anaphylaxis in Elderly Patients—Data From the European Anaphylaxis Registry |
title_short |
Anaphylaxis in Elderly Patients—Data From the European Anaphylaxis Registry |
title_full |
Anaphylaxis in Elderly Patients—Data From the European Anaphylaxis Registry |
title_fullStr |
Anaphylaxis in Elderly Patients—Data From the European Anaphylaxis Registry |
title_full_unstemmed |
Anaphylaxis in Elderly Patients—Data From the European Anaphylaxis Registry |
title_sort |
anaphylaxis in elderly patients—data from the european anaphylaxis registry |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Immunology |
issn |
1664-3224 |
publishDate |
2019-04-01 |
description |
Background: Elicitors and symptoms of anaphylaxis are age dependent. However, little is known about typical features of anaphylaxis in patients aged 65 years or more.Methods: The data from the Network for Online Registration of Anaphylaxis (NORA) considering patients aged ≥65 (elderly) in comparison to data from adults (18–64 years) regarding elicitors, symptoms, comorbidities, and treatment measures were analyzed.Results: We identified 1,123 elderly anaphylactic patients. Insect venoms were the most frequent elicitor in this group (p < 0.001), followed by drugs like analgesics and antibiotics. Food allergens elicited less frequently anaphylaxis (p < 0.001). Skin symptoms occurred less frequently in elderly patients (77%, p < 0.001). The clinical symptoms were more severe in the elderly (51% experiencing grade III/IV reactions), in particular when skin symptoms (p < 0.001) were absent. Most strikingly, a loss of consciousness (33%, p < 0.001) and preexisting cardiovascular comorbidity (59%, p < 0.001) were more prevalent in the elderly. Finally, adrenaline was used in 30% of the elderly (vs. 26% in the comparator group, p < 0.001) and hospitalization was more often required (60 vs. 50%, p < 0.001).Discussion and Conclusion: Anaphylaxis in the elderly is often caused by insect venoms and drugs. These patients suffer more often from cardiovascular symptoms, receive more frequently adrenaline and require more often hospitalization. The data indicate that anaphylaxis in the elderly tends to be more frequently life threatening and patients require intensified medical intervention. The data support the need to recognize anaphylaxis in this patient group, which is prone to be at a higher risk for a fatal outcome. |
topic |
anaphylaxis elderly insect venom drug hypersensitivity adrenaline hospitalization |
url |
https://www.frontiersin.org/article/10.3389/fimmu.2019.00750/full |
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AT stefanieaurich anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT sabinedollebierke anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT wojciechfrancuzik anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT mariabeatricebilo anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT georgechristoff anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT georgechristoff anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT montserratfernandezrivas anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT thomashawranek anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT claudiapfohler anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT iwonapoziomkowskagesicka anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT jeanmarierenaudin anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT evaoppel anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT kathrinscherer anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT reginatreudler anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry AT margittaworm anaphylaxisinelderlypatientsdatafromtheeuropeananaphylaxisregistry |
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doaj-7c5da283473048ffaa86c888bb8d32432020-11-24T21:07:00ZengFrontiers Media S.A.Frontiers in Immunology1664-32242019-04-011010.3389/fimmu.2019.00750448477Anaphylaxis in Elderly Patients—Data From the European Anaphylaxis RegistryStefanie Aurich0Sabine Dölle-Bierke1Wojciech Francuzik2Maria Beatrice Bilo3George Christoff4George Christoff5Montserrat Fernandez-Rivas6Thomas Hawranek7Claudia Pföhler8Iwona Poziomkowska-Gȩsicka9Jean-Marie Renaudin10Eva Oppel11Kathrin Scherer12Regina Treudler13Margitta Worm14Department of Dermatology, Venereology and Allergology, LICA-Comprehensive Allergy Center, University Hospital, Leipzig, GermanyDivision of Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDivision of Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyAllergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona, ItalyFaculty of Public Health, Medical University-Sofia, Sofia, BulgariaAllergy Outpatient Unit, Acibadem CityClinic, Medical Centre Tokuda, Sofia, BulgariaAllergy Department, Hospital Clinico San Carlos, Madrid, SpainDepartment of Dermatology, University Hospital of the Paracelsus Private Medical University, Salzburg, AustriaDepartment of Dermatology, Venereology and Allergology, Saarland University Medical Center, Homburg, GermanyClinical Allergology Department, Pomeranian Medical University in Szczecin, Szczecin, Poland0Presidency, Allergy Vigilance Network, Vandoeuvre les Nancy, France1Department of Dermatology and Allergy, University Hospital (LMU), Munich, Germany2Division of Allergy, Department of Dermatology, University of Basel, Basel, SwitzerlandDepartment of Dermatology, Venereology and Allergology, LICA-Comprehensive Allergy Center, University Hospital, Leipzig, GermanyDivision of Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyBackground: Elicitors and symptoms of anaphylaxis are age dependent. However, little is known about typical features of anaphylaxis in patients aged 65 years or more.Methods: The data from the Network for Online Registration of Anaphylaxis (NORA) considering patients aged ≥65 (elderly) in comparison to data from adults (18–64 years) regarding elicitors, symptoms, comorbidities, and treatment measures were analyzed.Results: We identified 1,123 elderly anaphylactic patients. Insect venoms were the most frequent elicitor in this group (p < 0.001), followed by drugs like analgesics and antibiotics. Food allergens elicited less frequently anaphylaxis (p < 0.001). Skin symptoms occurred less frequently in elderly patients (77%, p < 0.001). The clinical symptoms were more severe in the elderly (51% experiencing grade III/IV reactions), in particular when skin symptoms (p < 0.001) were absent. Most strikingly, a loss of consciousness (33%, p < 0.001) and preexisting cardiovascular comorbidity (59%, p < 0.001) were more prevalent in the elderly. Finally, adrenaline was used in 30% of the elderly (vs. 26% in the comparator group, p < 0.001) and hospitalization was more often required (60 vs. 50%, p < 0.001).Discussion and Conclusion: Anaphylaxis in the elderly is often caused by insect venoms and drugs. These patients suffer more often from cardiovascular symptoms, receive more frequently adrenaline and require more often hospitalization. The data indicate that anaphylaxis in the elderly tends to be more frequently life threatening and patients require intensified medical intervention. The data support the need to recognize anaphylaxis in this patient group, which is prone to be at a higher risk for a fatal outcome.https://www.frontiersin.org/article/10.3389/fimmu.2019.00750/fullanaphylaxiselderlyinsect venomdrug hypersensitivityadrenalinehospitalization |