Caregiver & Elder Care News
Most Allergic Deaths from Medications; Older People, African-Americans
Montefiore/Einstein research seeks risk factors to
allow physicians to develop preventative strategies
30, 2014 When we hear of allergy-related sudden death, most of us
probably think of something in the surrounding environment like a
plant, or something in the air. We would be wrong. Medications are the
leading cause of allergy-related sudden deaths in the U.S. And, the risk
of fatal drug-induced allergic reactions is increasing rapidly and is
particularly high among older people and African-Americans.
An analysis of death certificates from 1999 to 2010
was conducted by researchers at
College of Medicine of Yeshiva University. Their study was
published online today in the Journal of Allergy and Clinical
Anaphylaxis is the term used for a severe,
potentially life-threatening allergic reaction that can occur within
seconds or minutes following exposure to an allergen. Until now, data on
trends in anaphylactic deaths - or even the number of yearly deaths from
anaphylactic shock - has not been well-defined. One reason: unlike
countries such as the UK, the U.S. doesn't maintain a national registry
for anaphylaxis deaths.
"Anaphylaxis-related deaths in the U.S. have not
been well understood in recent years," said
, M.D., M.Sc. director, Drug Allergy Center, Allergy and
Immunology Division of Medicine, Montefiore Medical Center, and
assistant professor of medicine, Albert Einstein College, the lead
author of the study.
"We hope these findings will help in identifying
specific risk factors and allow physicians to formulate preventative
Dr. Jerschow and colleagues analyzed death
certificates from the U.S. National Mortality Database and found that
medication-related anaphylaxis was the most common cause of death (58.8
Additional causes identified included unspecified
anaphylaxis (19.3 percent), venom (15.2 percent) and food (6.7 percent).
Further analyses revealed fatal anaphylaxis due to medications, food and
unspecified allergens was significantly associated with African American
race and older age; and fatal anaphylaxis rates due to venom was more
common in white, older men.
Of the 2,458 deaths identified between 1999-2010,
1,446 were from medications. The culprit drugs were not specified in
most of the cases (approximately 74 percent). However, among those with
an identified culprit drug, nearly half were antibiotics, followed by
radiocontrast agents used during diagnostic imaging procedures and
chemotherapeutics that are used in treatment of cancer.
During the years studied, there was a significant
increase in fatal drug anaphylaxis, from 0.27 per million in 1999-2001
to 0.51 per million in 2008-2010. The increase in medication-related
anaphylaxis deaths likely relates to increased medication and
radiocontrast use, enhanced diagnosis and coding changes.
"Anaphylaxis has been dubbed 'the latest allergy
epidemic,'" said Dr. Jerschow.
"The U.S. and Australia have some of the highest
rates of severe anaphylaxis among developed countries. We hope these
results bring increased awareness of the need for a better understanding
of anaphylaxis deaths."
In addition to Dr. Jerschow, authors include Moira
M. Scaperotti B.S., and
Aileen P. McGinn,
Ph.D., both at Einstein, and Robert Lin, M.D., M.Sc., at Weill Cornell
Medical College. This research was supported in part by the Clinical and
Translational Science Award from the National Institutes of Health to
Albert Einstein College of Medicine (UL1 TR001073). The researchers
report no conflicts of interest.
About Montefiore Medical Center
As the University Hospital for Albert Einstein
College of Medicine, Montefiore is a premier academic medical center
nationally renowned for its clinical excellence, scientific discovery
and commitment to its community.
About Albert Einstein College of Medicine of
College of Medicine of Yeshiva University reports to be one
of the nations premier centers for research, medical education and
clinical investigation. http://