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Higher basal tryptase, asthma and loss of consciousness in anaphylaxis are associated with biphasic reactions
  • +5
  • Terence Langlois,
  • Pascale Nicaise,
  • Camille Taillé,
  • Patrick Natta,
  • Bruno Crestani,
  • Sylvie Chollet-Martin,
  • Luc de Chaisemartin,
  • Catherine Neukirch
Terence Langlois
Hopital Bichat - Claude-Bernard Service Pneumologie A

Corresponding Author:[email protected]

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Pascale Nicaise
Hopital Bichat - Claude-Bernard
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Camille Taillé
Hopital Bichat - Claude-Bernard Service Pneumologie A
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Patrick Natta
Hopital Bichat - Claude-Bernard Service Pneumologie A
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Bruno Crestani
Hopital Bichat - Claude-Bernard Service Pneumologie A
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Sylvie Chollet-Martin
Hopital Bichat - Claude-Bernard
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Luc de Chaisemartin
Hopital Bichat - Claude-Bernard
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Catherine Neukirch
Hopital Bichat - Claude-Bernard Service Pneumologie A
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Abstract

Background: Anaphylaxis is the more severe form of immediate hypersensitivity. It can be life-threatening and therefore requires fast and appropriate medical management. After a first hypersensitivity phase, a recurrence of symptoms without an elicitor re-exposure may occur, called a biphasic reaction. The aim of this study was to identify biological and clinical predictors of biphasic reactions in patients with anaphylaxis. Methods: We retrospectively compared patients with monophasic anaphylaxis to those with biphasic anaphylaxis from an allergology day hospital in a French university hospital between January 2017 and May 2020. Results: Among the 237 patients, the rate of biphasic reactions was 5.5% (n = 13). The odds of a biphasic reaction was increased with asthma (p = 0.021; odds ratio = 4 [95% confidence interval 1.05-14.81]) and loss of consciousness during anaphylaxis (p = 0.008) as compared with monophasic anaphylaxis. Basal tryptase levels were significantly higher with biphasic than monophasic anaphylaxis (p = 0.009). Conclusions: Asthma and unconsciousness during the first phase of anaphylaxis could be associated with a biphasic reaction . Elevated basal tryptase was linked to biphasic reactions, which should be further explored.