Anaphylaxis (a severe, systemic allergic reaction) can be life-threatening. While this life-threatening reaction is quite uncommon, among the commonest causes of anaphylaxis include drug allergies, food allergies, and insect bites and stings. People who are known to be susceptible to severe reactions (to, e.g., insect stings) often carry an emergency supply of a reliable, injectable antidote, usually an Epi-Pen or a variant thereof.
A new analysis published in The Journal of Allergy and Clinical Immunology reports that the most common causes of fatal allergic reactions are medications, including antibiotics and radiocontrast agents (dye injected for an XRay study).
In the study, led by Dr. Elina Jerschow, an assistant professor of medicine at the Albert Einstein College of Medicine in the Bronx, almost 2,500 anaphylaxis-related deaths occurring from 1999 to 2010 were identified using data from the National Center for Health Statistics. Almost 60 percent of the anaphylaxis-related deaths were caused by medications. Unspecified causes accounted for almost 20 percent, followed by insect bites/stings at over 15 percent, and food at almost 7 percent (the most common food-related allergies include peanuts and other nuts, and shellfish.)
The rates of drug-induced fatal anaphylaxis increased significantly over 12 years, from 0.27 per million in 1999 to 2001 to 0.51 per million in 2008 to 2010. The authors point out that part of this increase is likely due to coding changes on death certificates and enhanced diagnosis. But the authors also state that the increase is also likely due to increased medication and radiocontrast use. Regarding radiocontrast agents, Dr. Jerschow states, We are using more imaging studies than other countries, and they re potentially life-threatening.
ACSH s Dr. Josh Bloom says, Although the rates have doubled during that time, if you do the math, this comes out to 136 drug-based anaphylactic deaths per year. Yes some people do have very bad reactions to penicillins and some imaging agents. To put this in perspective, more than 33,000 people died last year from riding bicycles.