4.4 Article

Current situation of anaphylaxis in Japan: Data from the anaphylaxis registry of training and teaching facilities certified by the Japanese Society of Allergology - secondary publication

Journal

ALLERGOLOGY INTERNATIONAL
Volume 72, Issue 3, Pages 437-443

Publisher

JAPANESE SOC ALLERGOLOGY
DOI: 10.1016/j.alit.2022.12.003

Keywords

Adrenaline; Anaphylaxis; Drug hypersensitivity; Food hypersensitivity; Insect allergy

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This study conducted the first nationwide epidemiological survey on anaphylaxis in Japan. The results showed that children were the main population affected by anaphylaxis, with food and drugs being the most common triggers. Intramuscular injection of adrenaline was commonly used for treatment. The findings highlight the importance of comprehensive education and training on anaphylaxis.
Background: Anaphylaxis is a potentially fatal severe systemic hypersensitivity reaction that causes symptoms in multiple organs such as the skin, respiratory tract, and gastrointestinal tract; however, no nationwide epidemiological survey on anaphylaxis has been conducted in Japan. This survey aimed to elucidate the triggers and treatment of anaphylaxis in Japan. Methods: Between February 2015 and October 2017, we prospectively collected clinical data on the triggers and treatment of patients who developed anaphylaxis or were admitted to the emergency room with anaphylaxis in the training and teaching facilities of the Japanese Society of Allergology. Results: This study included 79 of the 451 affiliated facilities (18%), and a total of 767 patients were enrolled; 73% of them were aged <18 years and 7% had in-hospital triggers. The most common triggers were food (68%), drugs (12%), food-dependent exercise-induced anaphylaxis (5%), insects (4%), and oral immunotherapy (3%), with drugs being the most common in-hospital trigger and food being the most common out-of-hospital trigger. Intramuscular injection of adrenaline was administered therapeutically to 38% of the patients, with 10% requiring multiple doses. Adrenaline auto-injectors were used in 12% of out-of-hospital patients. Conclusions: The present survey revealed the most common triggers and treatments for anaphylaxis in Japan. Self-management and adrenaline administration as first-line treatment may not be done sufficiently. Therefore, it is necessary to thoroughly educate and train patients and physicians about anaphylaxis. (C) 2022 Japanese Society of Allergology. Published by Elsevier B.V.

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