Characteristics of food-related anaphylaxis in adult: a single center experience

초록

Background: Although anaphylaxis is a life-threatening condition that requires urgent medical care, the importance of food-related anaphylaxis in adults might be overlooked because of its rare occurrence. This study was performed to investigate the causes and clinical features of disease in adult patients with food-related anaphylaxis. Methods: Medical chart review was performed on the patients who visited the outpatient clinic or inpatient ward of the adult allergy department, and diagnosed with anaphylaxis between Jan 2003 and Dec 2013 in a single tertiary university hospital in Korea. Cases with food-related anaphylaxis were subsequently identified, and subgroup analyses were done to assess clinical characteristics of food related anaphylaxis. Results: Among 289 subjects with anaphylaxis, 48 subjects with food-related anaphylaxis (male 77.1%, aged 16-64 years) were identified. Of the 48 subjects, 27 (56.3%) were food-induced anaphylaxis (FIA) and 21 (43.7%) were food dependent exercise-induced anaphylaxis (FDEIA). Shrimp, buckwheat and pupa are leading cause of FIA, and wheat (71.4%) was the most common cause of FDEIA, followed by seafood and vegetables. The clinical manifestations of food-related anaphylaxis were cutaneous (100%), respiratory (72.9%), and cardiovascular (62.5%) respectively. In severity assessment, approximately 62.5% were classified as severe anaphylaxis. Portable epinephrine auto-injector was prescribed to 43.8% of patients. More than 2/3 of the patients with anaphylaxis were lost during follow-up period. Conclusion: Shrimp and buckwheat are the most common cause of FIA, and wheat is the most common cause of FDEIA. Because food-related anaphylaxis is not rare even in adult patients with anaphylaxis, and significant number of patients lost to follow-up, more comprehensive approaches will be required to control and prevent development of anaphylaxis.