Abstract
Background: Anaphylaxis is a severe systemic life-threatening reaction. The Iwate Prefectural Critical Care and Emergency Center plays the main role in providing emergency medical care in the central region of Iwate Prefecture and has received many anaphylactic cases. We report the epidemiological results of our anaphylactic cases with the purpose of ascertaining the circumstances surrounding anaphylaxis.
Material and Method: Between November 1980 and October 2009, 302 anaphylactic cases spanning 29 years were experienced in our critical care and emergency center. Retrospective medical record reviews were used to obtain patient data on cause, age, gender and initial manifestations.
Results: The mean patient age was 48.0 years, and there were more males than females. There were 193 cases (63.9%) of anaphylactic shock, eight (2.7%) of cardiopulmonary arrest, and four fatalities. Causes were bee venom in 148 (49.0%), medicine in 89 (29.4%), food in 58 (19.2%), food-dependent exercise-induced anaphylaxis in three (1.0%) and others four (1.3%) cases. Yellow jacket and wasp stings together comprised 47.9% of bee venom anaphylaxis cases. Non-steroidal anti-inflammatory drugs, antibiotics, over-the-counter medications and local anesthesia accounted for 75.7% of drug anaphylaxis cases. Seafood and buckwheat accounted for 56.9% of food anaphylaxis cases. Bee venom, seafood and buckwheat were thus causative agents in a large proportion of anaphylactic cases. The most common manifestations were cardiovascular (65.9%) and cutaneous (42.1%) symptoms.
Conclusion: The most common cause of anaphylaxis was bee venom, followed by drugs and food. Seafood (50.0%) and buckwheat (6.9%) accounted for a large proportion of causal foods. The high rate of bee venom anaphylaxis reflects the extensive areas of mountain forest and farmland, with many agriculture and forestry workers, in Iwate prefecture. Seafood anaphylaxis was connected to the consumer intentions of local residents while buckwheat anaphylaxis had an association with visitors from other prefectures. We considered the distinct dietary habits and culture of the rural population, as well as related industry influences, to account for the high proportion of anaphylaxis cases caused by bee venom and food products.
