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Evaluation of near-fatal reactions to allergen immunotherapy injections

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  • Additional Information
    • Affiliation:
      a From the Department of Internal Medicine, Division of Immunology and Allergy, University of Cincinnati
      b Gage Occupational and Environmental Health Unit, Department of Public Health Sciences, University of Toronto
    • Note:
      Supported by the Immunotherapy Committee of the American Academy of Allergy and Clinical Immunology (AAAAI).
      Cincinnati, Ohio, and Toronto, Ontario, Canada
    • Keywords:
      Immunotherapy
      anaphylaxis
      near-fatal reactions
      asthma
      epinephrine
    • Subject Terms:
    • Abstract:
      Background The overall incidence of near-fatal reactions (NFRs) after immunotherapy injections is unknown. Investigation of NFRs might identify preventive strategies that could avert fatal immunotherapy reactions.
    • Abstract:
      Methods In a brief survey of fatal reactions (FRs) and NFRs administered to practicing allergists, 273 of 646 respondents reported NFRs after immunotherapy injections; a NFR was defined as respiratory compromise, hypotension, or both requiring emergency epinephrine. Respondents were mailed a 105-item questionnaire regarding the details of NFRs and circumstances of these events.
    • Abstract:
      Results During the period from 1990 through 2001, the incidence of unconfirmed NFRs was estimated at 23 per year (5.4 events per million injections). There were 68 confirmed NFRs on the basis of responses to the long survey, with a mean case incidence of 4.7 per year or 1 NFR per million injections. Asthma was present in 46% of near-fatal reactors and in 88% of fatal reactors identified in this study. Hypotension was reported in 80% and respiratory failure occurred in 10% of NFRs and exclusively in asthmatic subjects. Epinephrine was delayed or not administered in 6% of NFRs versus 30% of reported FRs (OR, 7.3; 95% CI, 1.4-39.8; P = .01).
    • Abstract:
      Conclusions Confirmed NFRs were 2.5 times more frequent than FRs. Favorable outcomes of NFRs when compared with FRs could be related to lower asthma prevalence and appropriate management of life-threatening anaphylaxis.
    • ISSN:
      0091-6749
    • Accession Number:
      10.1016/j.jaci.2005.10.010
    • Accession Number:
      S0091674905022645
    • Copyright:
      Copyright @ 2006 American Academy of Allergy, Asthma and Immunology Published by Mosby, Inc. All rights reserved.
  • Citations
    • ABNT:
      AMIN, H. S.; LISS, G. M.; BERNSTEIN, D. I. Evaluation of near-fatal reactions to allergen immunotherapy injections. The Journal of Allergy and Clinical Immunology, [s. l.], v. 117, n. 1, p. 169–175, 2006. DOI 10.1016/j.jaci.2005.10.010. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=S0091674905022645. Acesso em: 24 out. 2020.
    • AMA:
      Amin HS, Liss GM, Bernstein DI. Evaluation of near-fatal reactions to allergen immunotherapy injections. The Journal of Allergy and Clinical Immunology. 2006;117(1):169-175. doi:10.1016/j.jaci.2005.10.010
    • APA:
      Amin, H. S., Liss, G. M., & Bernstein, D. I. (2006). Evaluation of near-fatal reactions to allergen immunotherapy injections. The Journal of Allergy and Clinical Immunology, 117(1), 169–175. https://doi.org/10.1016/j.jaci.2005.10.010
    • Chicago/Turabian: Author-Date:
      Amin, Hetal S., Gary M. Liss, and David I. Bernstein. 2006. “Evaluation of Near-Fatal Reactions to Allergen Immunotherapy Injections.” The Journal of Allergy and Clinical Immunology 117 (1): 169–75. doi:10.1016/j.jaci.2005.10.010.
    • Harvard:
      Amin, H. S., Liss, G. M. and Bernstein, D. I. (2006) ‘Evaluation of near-fatal reactions to allergen immunotherapy injections’, The Journal of Allergy and Clinical Immunology, 117(1), pp. 169–175. doi: 10.1016/j.jaci.2005.10.010.
    • Harvard: Australian:
      Amin, HS, Liss, GM & Bernstein, DI 2006, ‘Evaluation of near-fatal reactions to allergen immunotherapy injections’, The Journal of Allergy and Clinical Immunology, vol. 117, no. 1, pp. 169–175, viewed 24 October 2020, .
    • MLA:
      Amin, Hetal S., et al. “Evaluation of Near-Fatal Reactions to Allergen Immunotherapy Injections.” The Journal of Allergy and Clinical Immunology, vol. 117, no. 1, Jan. 2006, pp. 169–175. EBSCOhost, doi:10.1016/j.jaci.2005.10.010.
    • Chicago/Turabian: Humanities:
      Amin, Hetal S., Gary M. Liss, and David I. Bernstein. “Evaluation of Near-Fatal Reactions to Allergen Immunotherapy Injections.” The Journal of Allergy and Clinical Immunology 117, no. 1 (January 1, 2006): 169–75. doi:10.1016/j.jaci.2005.10.010.
    • Vancouver/ICMJE:
      Amin HS, Liss GM, Bernstein DI. Evaluation of near-fatal reactions to allergen immunotherapy injections. The Journal of Allergy and Clinical Immunology [Internet]. 2006 Jan 1 [cited 2020 Oct 24];117(1):169–75. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=edselp&AN=S0091674905022645