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Michael M. Peng, PhD; Hershel Jick, MD

Arch Intern Med. 2004;164:317-319.

Background  Anaphylaxis is an acute and potentially fatal systemic reaction usually caused by mast cell–mediated release of histamine. Symptoms can vary in onset, appearance, and severity. Some common symptoms include weakness, dizziness, flushing, angioedema, urticaria, nasal congestion, and sneezing. Severe symptoms include upper respiratory tract obstruction, hypotension, vascular collapse associated with angioedema and urticaria, gastrointestinal distress, cardiovascular arrhythmias, and/or arrest.

Methods  We conducted an observational follow-up study encompassing approximately 8 million person-years based on the UK General Practice Research Database for the period January 1, 1994, to December 31, 1999, which quantified the frequency, type, and severity of a clinical diagnosis of anaphylaxis.

Results  Based on 675 cases of anaphylaxis, we estimate the incidence to be 8.4 per 100 000 person-years. Approximately 10% of cases had hypotension and shock that required urgent treatment. The most common causes were insect stings and oral medicines.

Conclusion  Anaphylaxis is an uncommon illness that has multiple causes and can be life-threatening.

From the Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Mass. The authors have no relevant financial interest in this article.

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