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

N. U. Khan, N. Shakeel, A. Makda, A. S. Mallick, M. Ali memon, S. H. Hashmi, U. R. Khan, Junaid Razzak

Research output: Contribution to journalArticle

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 definitionAim: To review the incidence, clinical presentation, cause and outcome of anaphylaxis at a tertiary-care centre in a low-income country.Design: Retrospective, case seriesMethods: 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 SymposiumResults: 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.

Original languageEnglish (US)
Article numberhct179
Pages (from-to)1095-1101
Number of pages7
JournalQJM
Volume106
Issue number12
DOIs
StatePublished - Dec 2013
Externally publishedYes

Fingerprint

Pakistan
Anaphylaxis
Tertiary Healthcare
Tertiary Care Centers
Incidence
Allergens
Epinephrine
Skin
Food Hypersensitivity
Resuscitation
Pharmaceutical Preparations
Cause of Death
Hypersensitivity
Epidemiology
History
Food
Infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Khan, N. U., Shakeel, N., Makda, A., Mallick, A. S., Ali memon, M., Hashmi, S. H., ... Razzak, J. (2013). Anaphylaxis: Incidence, presentation, causes and outcome in patients in a tertiary-care hospital in Karachi, Pakistan. QJM, 106(12), 1095-1101. [hct179]. https://doi.org/10.1093/qjmed/hct179

Anaphylaxis : Incidence, presentation, causes and outcome in patients in a tertiary-care hospital in Karachi, Pakistan. / Khan, N. U.; Shakeel, N.; Makda, A.; Mallick, A. S.; Ali memon, M.; Hashmi, S. H.; Khan, U. R.; Razzak, Junaid.

In: QJM, Vol. 106, No. 12, hct179, 12.2013, p. 1095-1101.

Research output: Contribution to journalArticle

Khan, NU, Shakeel, N, Makda, A, Mallick, AS, Ali memon, M, Hashmi, SH, Khan, UR & Razzak, J 2013, 'Anaphylaxis: Incidence, presentation, causes and outcome in patients in a tertiary-care hospital in Karachi, Pakistan', QJM, vol. 106, no. 12, hct179, pp. 1095-1101. https://doi.org/10.1093/qjmed/hct179
Khan NU, Shakeel N, Makda A, Mallick AS, Ali memon M, Hashmi SH et al. Anaphylaxis: Incidence, presentation, causes and outcome in patients in a tertiary-care hospital in Karachi, Pakistan. QJM. 2013 Dec;106(12):1095-1101. hct179. https://doi.org/10.1093/qjmed/hct179
Khan, N. U. ; Shakeel, N. ; Makda, A. ; Mallick, A. S. ; Ali memon, M. ; Hashmi, S. H. ; Khan, U. R. ; Razzak, Junaid. / Anaphylaxis : Incidence, presentation, causes and outcome in patients in a tertiary-care hospital in Karachi, Pakistan. In: QJM. 2013 ; Vol. 106, No. 12. pp. 1095-1101.
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AU - Makda, A.

AU - Mallick, A. S.

AU - Ali memon, M.

AU - Hashmi, S. H.

AU - Khan, U. R.

AU - Razzak, Junaid

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N2 - 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 definitionAim: To review the incidence, clinical presentation, cause and outcome of anaphylaxis at a tertiary-care centre in a low-income country.Design: Retrospective, case seriesMethods: 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 SymposiumResults: 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.

AB - 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 definitionAim: To review the incidence, clinical presentation, cause and outcome of anaphylaxis at a tertiary-care centre in a low-income country.Design: Retrospective, case seriesMethods: 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 SymposiumResults: 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.

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