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Post-Mortem Study Assesses Fatal Anaphylaxis

In most cases, anaphylactic reaction develops soon after exposure and may cause death within one hour

WEDNESDAY, March 21 (HealthDay News) -- Fatal anaphylactic reactions usually develop within 30 minutes after allergen exposure and often cause death within 60 minutes, according to study findings published in the March issue of the Annals of Allergy, Asthma and Immunology. Elderly patients with comorbid conditions may be at greater risk of mortality due to anaphylaxis.

Paul A. Greenberger, M.D., of Northwestern University Feinberg School of Medicine in Chicago, and colleagues conducted a retrospective case review of 25 unselected cases of documented fatal anaphylaxis, seven of which included measurements of serum tryptase concentrations.

The researchers found that medication reactions accounted for seven deaths, while the rest were due to radiocontrast material, Hymenoptera stings and food exposure. In 21 cases, the anaphylactic reaction began within 30 minutes of exposure, and in 13 cases death occurred within 60 minutes. In 22 of the 25 cases, the researchers found that there was at least one significant comorbidity.

"Comorbidities were frequent, consisting primarily of ischemic heart disease," the authors write. "Specific anatomical findings were present in 18 of 23 autopsy examinations, but urticaria was identified in only one case. Epinephrine administration by the patient seemed to have occurred in just one of five cases."

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