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Author Topic: Biphasic Anaphylaxis: systematic review of lit  (Read 3838 times)

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Offline SilverLining

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Biphasic Anaphylaxis: systematic review of lit
« on: March 06, 2014, 07:51:58 AM »
http://www.aacijournal.com/content/10/S1/A5

Biphasic anaphylaxis: a systematic review of the literature
Douglas P Mack


Offline SilverLining

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Re: Biphasic Anaphylaxis: systematic review of lit
« Reply #1 on: March 06, 2014, 07:53:41 AM »
Quote
Overall frequency of biphasic reactions was 7.36% of anaphylactic reactions with prospective studies reporting a frequency of 9.07%. Mean time to the second phase of BA was 8.13 hours (95% CI, 6.13-10.14) with similar times between both pediatric and adult populations.

The stuff nightmares are made of.

Offline spacecanada

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Re: Biphasic Anaphylaxis: systematic review of lit
« Reply #2 on: March 06, 2014, 10:00:11 AM »
I am surprised at the mean time of onset being 8.13 hours, wow!  I've had a biphasic reaction at ~2 hours and thought the 4-hour observation was because biphasic reactions typically happen in that window.  How terrifying!  :-[
ANA peanuts, tree nuts, wheat, potato, sorghum

Offline CMdeux

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Re: Biphasic Anaphylaxis: systematic review of lit
« Reply #3 on: March 06, 2014, 10:20:12 AM »
The most overtly horrifying reaction DD ever had was a biphasic phase II at 2yo.

time to onset was 4 hr on the dot from the initial reaction, which was so non-specific as to not be fully recognizable as "allergic" in nature.


The late phase was unbelievably fast (seconds to full anaphylaxis) and I still have trouble wrapping my head around how severe that reaction was-- it was hard to tell whether DD was choking on mucous or if her airways were that swollen... but she was COVERED with hives-on-top-of-hives, vomiting, and then... more ominously, barely conscious.   :hiding:

I've never-- ever-- been so glad to live 90s from the emergency room doors.  NEVER.  Longest car ride of my life.

We've also seen biphasics from allergy shots-- those tended to be 8hr on the nose.  It was so predictable that for a while, our allergist had us on his "call in the morning" list the day after an allergy injection.    (I  :heart: him so much.)



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Western U.S.

Offline Macabre

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Re: Biphasic Anaphylaxis: systematic review of lit
« Reply #4 on: March 06, 2014, 10:55:26 AM »
At the 8 hour mark for DS once. And thT was after accidental ingestion because he are a snack after holding a hockey stick in PE without washing hands (snack was after PE). And the initial symptoms?  Persistent asthma that wasn't abated by inhaler and spaciness. Yep.

The biphasic symptoms: GI symptoms, impending doom, chest tightness, throat tightness. At 8 hours.
Me: Sesame, shellfish, chamomile, sage
DS: Peanuts

Offline rebekahc

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Re: Biphasic Anaphylaxis: systematic review of lit
« Reply #5 on: March 06, 2014, 11:47:55 AM »
DD's worst reaction (at age 7) was probably bi-phasic, but we're still stumped as to when the initial reaction started.

Lunch at school ~11:00 a.m.
One hive on chest ~3:00 p.m. (unsure if she had any symptoms prior since she was in school)
Spreading rash/tiny hives ~6:00 p.m.
Full blown anaphylaxis with breathing difficulty ~8:00 (nothing to eat since lunch and a bag of Fritos after school - only confirmed allergy SF) received Epi and Benadryl by me and then IV Pepcid and steroids at the hospital
Grade V anaphylaxis including respiratory arrest, cardiac arrest and LOC ~10:00 p.m.

And now I'm shaking and feel like I want to puke.
  :hiding:
TX - USA
DS - peanut, tree nut, milk, eggs, corn, soy, several meds, many environmentals. Finally back on Xolair!
DD - mystery anaphylaxis, shellfish.
DH - banana/avocado, aspirin.  Asthma.
Me - peanut, tree nut, shellfish, banana/avocado/latex,  some meds.

Offline SilverLining

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Re: Biphasic Anaphylaxis: systematic review of lit
« Reply #6 on: March 06, 2014, 12:02:17 PM »
Mean time = average time ?

Since many have a biphasic reaction within 2 hours.....that means many could be beyond 8 hours. 

Offline spacecanada

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Re: Biphasic Anaphylaxis: systematic review of lit
« Reply #7 on: March 07, 2014, 03:01:54 PM »
Mean time = average time ?

Since many have a biphasic reaction within 2 hours.....that means many could be beyond 8 hours.

Yes, mean = average.  The report states the study group had biphasic reactions from 1 to 72 hours after the initial reaction.  S.C.A.R.Y!!

My phase 2 reaction was pretty scary too, although not quite as frightening as some of yours.   :grouphug:
ANA peanuts, tree nuts, wheat, potato, sorghum