A new Canadian study, led by a team from the Research Institute of McGill University Health Center (RI-MUHC), is shedding light on anaphylaxis due to an unknown trigger (AUT) – an unpredictable and potentially fatal allergic reaction to How surprisingly little is known.
The study, published in The Journal of Allergy and Clinical Immunology: In Practice, There have been about 4,000 cases of anaphylaxis treated in Canadian emergencies from 2011 to 2018. Common causes of anaphylaxis include food, medication, insect bites, latex and exercise, but in some episodes no definite cause can be determined. With food anaphylaxis, avoiding the triggering food is a fundamental principle of management; but with TUE, the possibility of a sudden life-threatening anaphylactic episode may occur at any time.
"In our study, 7.5% of anaphylaxis cases were caused by an unknown cause, and we found that TRE treatment and follow-up were sub-optimal and inconsistent both inside and outside the hospital," says Dr Moshe Ben- Shoshan, a pediatric allergist and immunologist at the McGill University Health Research Center (RI-MUHC) and MUHC's Montreal Children's Hospital.
"Specifically, epinephrine was underused and antihistamines were the main treatment for TUE: 46% of the patients in our study received antihistamines before they arrived at the hospital and 55% of the patients received antihistamines in the emergency department of the hospital, "adds BenShoshan. , who is also an assistant professor of pediatrics at McGill University.
This research is the first large-scale longitudinal study to assess the clinical characteristics, treatment and follow-up of TUE cases across Canada. The study is part of a large national project and database called the Canada-Cruz Anaphylaxis Registry (C-CARE), which tracks rates, triggers and management of anaphylaxis in different Canadian provinces and regions.
Among the other findings of the study:
- Almost one-fifth of TUE patients received no epinephrine self-injure prescription;
- Adults were less likely to receive a prescription for epinephrine self-injector than children;
- Only 56 percent of TUE patients were referred to an allergist, most of them children;
- Of the patients evaluated by an allergist, a trigger for their reaction was identified in 38 percent of the cases.
"The underutilization of epinephrine and the low rates of referral to an allergist, especially in adults with TUE, highlight the need for clear guidelines and educational programs for diagnosis and treatment," says first author of the study, Michelle Le, a medical student of McGill University. and an AllerGen trainee.
"The important finding of this study is that there are significant discrepancies in the treatment and follow-up of TUE patients that should be addressed in order to ensure prompt and appropriate treatment of anaphylaxis."
About AllerGen NCE Inc.
AllerGen NCE Inc., the Allergy, Genes and Environment Network (est. 2004), is a national research network dedicated to improving the quality of life of people suffering from allergic and related immune diseases. Funded by Industry Canada through the federal Center for Excellence Networks (NCE) program, the Network is headquartered at McMaster University in Hamilton.
About the MUHC Research Institute
The Research Institute of McGill University Health Center (RI-MUHC) is a world-renowned biomedical and health research center. The Institute, which is affiliated with the McGill University School of Medicine, is the research arm of the McGill University Health Center (MUHC) – an academic health center located in Montreal, Canada, which has a mandate to focus complex care within your university. community. RI-MUHC supports more than 460 researchers and approximately 1,300 research trainees dedicated to a broad spectrum of fundamental, clinical, and health outcomes research at the Glen sites and MUHC Montreal General Hospital. Its research facilities provide a dynamic, multidisciplinary environment that encourages collaboration and leverages discovery with the goal of improving the health of individual patients throughout their lifespan. RI-MUHC is funded in part by the Quebec-Santé Research Fund (FRQS). rimuhc.ca.