Increase in anaphylaxis-related hospitalizations but no increase in fatalities: an analysis of United Kingdom national anaphylaxis data, 1992-2012.

Background: The incidence of anaphylaxis might be increasing. Data for fatal anaphylaxis are limited because of the rarity of this outcome.

Objective: We sought to document trends in anaphylaxis admissions and fatalities by age, sex, and cause in England and Wales over a 20-year period.

IgE sensitization to the nonspecific lipid-transfer protein Ara h 9 and peanut-associated bronchospasm.

Allergen component analysis is now available in many laboratories. The aim of this study was to examine the possible association between peanut allergen IgE components and severity of clinical reactions in patients with a history of peanut allergy. Data and sera collected from 192 patients within the Manchester Allergy Research Database and Serum Bank were used in this retrospective study.

The purification and characterisation of allergenic hazelnut seed proteins.

A lipid transfer protein (LTP, Cor a 8) together with the 11S (Cor a 9) and 7S seed storage globulins (Cor a 11) are major food allergens present in hazelnut. Methods are described for their purification and characterisation using in-gel tryptic digestion mass spectrometry to confirm their identities and circular dichroism and Fourier-transform infrared spectroscopies to demonstrate that they are authentically folded. Preliminary immunochemical studies have also confirmed that the purified preparations retain their immunological properties in terms of immunoglobulin E binding, determined by immunoblotting using serum from hazelnut allergic patients.

When should self-injectible epinephrine be prescribed for food allergy and when should it be used?

Purpose Of Review: To explore why epinephrine autoinjectors have failed to prevent fatal food anaphylaxis and how this problem might be solved.

Recent Findings: Autoinjectors cannot save lives when they are used too late, misused, not carried, or when an inadequate dose is absorbed; food allergy-induced asthma may not respond when asthma management is suboptimal. New markers for severe reactions have been published.

Emergency treatment of anaphylactic reactions--guidelines for healthcare providers.

*The UK incidence of anaphylactic reactions is increasing. *Patients who have an anaphylactic reaction have life-threatening airway and, or breathing and, or circulation problems usually associated with skin or mucosal changes. *Patients having an anaphylactic reaction should be treated using the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach.

Factors predicting anaphylaxis to peanuts and tree nuts in patients referred to a specialist center.

Background: Although acute allergic reactions after ingestion of peanuts and tree nuts are common, fatalities are rare. Other than patients with coexisting asthma, it is currently not possible to predict which patients are most likely to develop severe reactions.

Objective: The aim of this study was to determine which clinical and laboratory parameters best predict the likelihood of severe allergic reactions.

IgE-mediated food allergy diagnosis: Current status and new perspectives.

In June 2005, the work of the EU Integrated Project EuroPrevall was started. EuroPrevall is the largest research project on food allergy ever performed in Europe. Major aims of the project are to generate for the first time reliable data on the prevalence of food allergies across Europe and on the natural course of food allergy development in infants.

Anaphylaxis: can we tell who is at risk of a fatal reaction?

Purpose Of Review: Anaphylaxis is frightening and patients commonly fear their next reaction will be fatal. This review looks at the characteristics of fatal reactions to find if a fatal recurrence is predictable.

Recent Findings: Most publications on fatal anaphylaxis are case reports that do not help predict risks.

Fatal anaphylaxis in the UK, 1992-2001.

Each year in the UK, around nine deaths are attributed to anaphylaxis to pharmaceuticals, six to food and four to stings. I have identified 214 deaths associated with anaphylaxis, and have sufficient information for 196 to determine that 88 deaths were due to shock, 96 to asphyxia. Five deaths followed epinephrine overdose, seven were complicated by disseminated intravascular coagulation.