Korean J Med.  2015 Mar;88(3):281-287. 10.3904/kjm.2015.88.3.281.

Drug-Induced Anaphylaxis in a Single Korean Tertiary Hospital

• Moon IJ
• Park HJ
• Kim SR
• Koh BS
• Leem DW
• Park KH
• Lee JH
• Park JW

• KMID: 2082587
• DOI: http://doi.org/10.3904/kjm.2015.88.3.281

Abstract

BACKGROUND/AIMS
Drug-induced anaphylaxis (DIA) is a severe, acute, and potentially life-threatening condition. In Korea, only a few well-documented cases of DIA have been described. Therefore, the aim of this study was to investigate the clinical characteristics, causes, and management of DIA in a single Korean medical institute.
METHODS
This was a retrospective medical record review of all DIA patients who visited the in-patient, out-patient, and emergency departments of our hospital from January 1 2006 to October 30 2013.
RESULTS
Among 605 cases of anaphylaxis, 167 were drug-induced. The culprit drugs were contrast agents (43 cases, 25.7%), antibiotics (38, 22.8%), non-steroidal anti-inflammatory drugs (35, 21.0%), anti-cancer drugs (22, 13.2%), parenteral vitamins (9, 5.4%), ranitidine (6, 3.6%), and neuromuscular blockers (3, 1.8%). The most common organ-specific symptoms/signs were cardiovascular (74.3%), cutaneous (71.3%), respiratory (55.7%), and gastrointestinal manifestations (19.2%). In most cases, DIA was treated with antihistamines (77.2%) and systemic corticosteroids (76.5%); the use of epinephrine was considerably less frequent (35.3%).
CONCLUSIONS
In our institution, contrast agents were the leading cause of DIA. Although epinephrine is the drug of choice in the treatment of acute anaphylaxis, fewer than 50% of the study patients received epinephrine to treat DIA.

Keyword

Anaphylaxis; Epidemiology; Epinephrine; Adverse drug reaction

MeSH Terms

Adrenal Cortex Hormones
Anaphylaxis*
Anti-Bacterial Agents
Contrast Media
Drug-Related Side Effects and Adverse Reactions
Emergency Service, Hospital
Epidemiology
Epinephrine
Histamine Antagonists
Humans
Korea
Medical Records
Neuromuscular Blockade
Neuromuscular Blocking Agents
Outpatients
Ranitidine
Retrospective Studies
Tertiary Care Centers*
Vitamins
Adrenal Cortex Hormones
Anti-Bacterial Agents
Contrast Media
Epinephrine
Histamine Antagonists
Neuromuscular Blocking Agents
Ranitidine
Vitamins