SURVEY OF FATALITIES FROM SKIN TESTING AND IMMUNOTHERAPY, 1985 TO 1989

[摘要] Purpose of the Study. This study was a survey of fatalities from skin testing and immunotherapy performed by the American Academy of Allergy and Immunology (AAAI) for the period 1985 to 1989. (An initial study dating from 1959 to 1984 was reported by Lockey in 1987 ( J Allergy Clin Immunol. 1987;79:660).)Methods. Questionnaires were sent to all members of the AAAI and ACAI requesting reports of any fatalities known to have been associated with skin testing or immunotherapy. An extensive clinical history of these fatalities was obtained and reviewed.Findings. Seventeen fatalities were associated with immunotherapy from 1985 to 1989 (in this same period, no fatalities were reported with skin testing). The mean age of the patients who died was 36 years; 69% were female. Of note, four patients were 18 years of age or younger. Of the patients who died, 76% had asthma, and most were reported to have had factors associated with increased severity. High allergic sensitivity was reported by 71%; 36% reported prior systemic reactions. Additional factors associated with fatalities were: changing to a new vial of extract (5), dosing error or inappropriate dose adjustment (5), allergen season (3), symptoms before injection (4), no waiting after injection (2), and home injection (1). The authors note that the annual fatality rate for administration of allergen extracts in the United States remains low: one fatality per 2 million doses, but that additional educational efforts to reduce the fatality rate are needed.Reviewer's Comments. The observation that 76% of the fatalities occurred in patients with asthma is similar to the observation that patients who die from stinging insect hypersensitivity and food-induced anaphylaxis are more likely asthmatics.

[学科分类] 儿科学