Risk Factors for Near-Anaphylaxis

[GoingNuts]

From Medscape:

Study Flags Risk Factors for Near-Fatal Anaphylaxis
Edited by Mandeep Singh Rawat
June 09, 2025
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TOPLINE:

A study of more than 2600 cases of food-induced anaphylaxis found that near-fatal and fatal reactions occurred in 1.7% of cases and that a history of asthma or having peanut as the trigger predicted greater anaphylaxis severity.

METHODOLOGY:

Researchers retrospectively analyzed cases of food-induced anaphylaxis recorded in a French database from 2002 to 2021 and compared near-fatal and fatal cases (grade 4) with severe cases (grade 3) to identify risk factors associated with higher severity.
They focused on 725 patients (mean age, 28.3 years; 53.7% men; 46.9% children) who had grade 3 anaphylaxis (n = 681) or grade 4 anaphylaxis (n = 44; 19 deaths).
TAKEAWAY:

Peanuts were the most frequent trigger, accounting for 101 cases (13.9%) of all grade 3 or grade 4 cases.
Asthma diagnosis (odds ratio [OR], 3.41; P =.002) and having peanut as the culprit food trigger (OR, 3.46; P =.014) were significant predictors of grade 4 anaphylaxis.
Of the grade 4 cases, 26 occurred in children and 18 occurred in adults.
IN PRACTICE:

Patients at a higher risk for severe reactions "should benefit from personalized management strategies such as oral immunotherapy and biotherapy," the authors of the study wrote.

SOURCE:

Guillaume Pouessel, MD, PhD, with Centre Hospitalier de Roubaix, Roubaix, France, was the corresponding author of the study, which was published online on May 29 in Clinical & Experimental Allergy.