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Phenotype of drug-induced anaphylaxis depends on the eliciting drug - data from the European Anaphylaxis Registry
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  • Theresa Hanschmann,
  • Wojciech Francuzik,
  • Sabine Dölle-Bierke,
  • Kathrin Scherer Hofmeier,
  • Linus Grabenhenrich,
  • Franziska Ruëff,
  • Jean-Marie Renaudin,
  • Claudia Pföhler,
  • Regina Treudler,
  • Bilo M.Beatrice,
  • Roland Lang,
  • Luis Felipe Ensina,
  • George Christoff,
  • Victoria Cardona,
  • Nicola Wagner,
  • Norbert Reider,
  • Sabine Müller,
  • Heinrich Dickel,
  • Margitta Worm
Theresa Hanschmann
Charite Universitatsmedizin Berlin

Corresponding Author:[email protected]

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Wojciech Francuzik
Charite Universitatsmedizin Berlin
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Sabine Dölle-Bierke
Charite Universitatsmedizin Berlin
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Kathrin Scherer Hofmeier
Kantonsspital Aarau Klinik fur Chirurgie
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Linus Grabenhenrich
Charite Universitatsmedizin Berlin
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Franziska Ruëff
Ludwig-Maximilians-Universitat Munchen Biomedizinisches Centrum Munchen
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Jean-Marie Renaudin
Centre Regional de Pharmacovigilance et d'information sur les medicaments Nancy
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Claudia Pföhler
Universitat des Saarlandes - Campus Homburg
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Regina Treudler
Universitatsklinikum Leipzig Klinik und Poliklinik fur Dermatologie Venerologie und Allergologie
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Bilo M.Beatrice
Universita Politecnica delle Marche
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Roland Lang
Paracelsus Medizinische Privatuniversitat
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Luis Felipe Ensina
Universidade Federal de Sao Paulo Disciplina de Alergia Imunologia Clinica e Reumatologia
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George Christoff
Medicinski universitet-Sofia
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Victoria Cardona
Hospital Universitari Vall d'Hebron Servei de Medicina Interna
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Nicola Wagner
Friedrich-Alexander-Universitat Erlangen-Nurnberg
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Norbert Reider
Medizinische Universitat Innsbruck Biocenter
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Sabine Müller
Universitatsklinikum Freiburg
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Heinrich Dickel
Universitatsklinikum der Ruhr-Universitat Bochum
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Margitta Worm
Charite Universitatsmedizin Berlin
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Introduction and objective Drugs are a frequent cause of severe anaphylactic reactions. Clinical epidemiology of drug-induced anaphylaxis (DIA) supports the identification of the most frequent eliciting drug groups, risk factors, symptoms and treatment procedures. Our aim was to analyze data to promote better recognition and long-term management of affected individuals. Methods Data from the European Anaphylaxis Registry (2007-2019) with 1,815 cases of drug-induced anaphylaxis were analyzed regarding demographics, elicitors, symptoms, comorbidities, and treatment. Results The most frequent eliciting groups of drugs were analgesics (41.27%) – with non-steroidal anti-inflammatory drugs (NSAIDs) being the most common subgroup (65.42%) – antibiotics (33.17%), local anesthetics (7.38%) and radiocontrast media (5.18%). Adrenaline was used more often in patients with DIA (23.20%) than in anaphylaxis due to other causes (17.82%). The majority of events occurred in female patients (65.34%), although they were admitted to hospital (29.01%) or an intensive care unit (ICU) (9.61%) less often. Skin symptoms were most common (84.02%), while gastrointestinal symptoms were reported less frequently (30.25%). Compared to other anaphylactic reactions in the registry (food/insects) severe reactions occurred significantly more often in DIA (5.62% vs. 1.67%). Hospitalization (31.63%) and ICU admission rates (11.85%) were significantly higher in DIA than anaphylactic reactions to other elicitors (27.58% and 5.45%). Conclusions DIA affects middle aged females more frequently and is more severe in elderly males in the sample observed. Analgesics and antibiotics are the leading causes of DIA. Adrenaline was rarely administered to patients, even though it is recommended by guidelines.