title: Epidemiology of drug-induced anaphylaxis in a tertiary hospital in Korea.
abstract: BACKGROUND
  Epidemiology and risk factors of drug-induced anaphylaxis are difficult to estimate due to lack of confirmative diagnosis and under reporting. Here we report the current state of drug-induced anaphylaxis in Korea based on an in-hospital pharmacovigilance database in a tertiary hospital.
  
  
  METHODS
  This study is a retrospective analysis of drug-induced anaphylaxis, reported to an in-hospital pharmacovigilance center in Seoul National University Hospital from June 2009 to May 2013. Anaphylaxis occurred in patients under 18 years of age or developed by medications administered from outside pharmacies or hospitals were excluded. We assessed causative drug, incidence per use of each drug and risk factors of fatal anaphylactic shock.
  
  
  RESULTS
  A total of 152 in-hospital drug-induced anaphylaxis cases were reported during the study period. The single most frequently reported drug was platinum compound and the incidence of anaphylaxis and anaphylactic shock in platinum compounds users was 2.84 and 1.39 per 1000 patients use. Risk factors of anaphylactic shock among total anaphylaxis cases were identified as older age ≥70 years [Odd's ratio (OR), 5.86; 95% confidence interval (CI), 1.70-20.14]. The use of iodinated contrast media (OR, 6.19; 95% CI, 1.87-20.53) and aminosteroid neuromuscular blocking agent (NMBA) (OR, 12.82; 95% CI, 1.50-109.92) were also a risk factor for the development of anaphylactic shock.
  
  
  CONCLUSIONS
  Platinum compounds are the most commonly reported causative agents of in-hospital drug-induced anaphylaxis. Older age ≥70 years and drugs such as iodinated contrast media and aminosteroid NMBA are related with high risk of anaphylactic shock.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea; Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea.
authors.forename: Han-Ki
authors.initials: HK
authors.lastname: Park
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea; Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, South Korea.
authors.forename: Min-Gyu
authors.initials: MG
authors.lastname: Kang
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea; Department of Internal Medicine, Seoul National University Hospital Boramae Medical Center, Seoul, South Korea.
authors.forename: Min-Suk
authors.initials: MS
authors.lastname: Yang
authors.affiliation: Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea; Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea.
authors.forename: Jae-Woo
authors.initials: JW
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea.
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, South Korea. Electronic address: helenmed@snu.ac.kr.
authors.forename: Hye-Ryun
authors.initials: HR
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D015897:Comorbidity; D003287:Contrast Media / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D062486:Public Health Surveillance; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D062606:Tertiary Care Centers; D047090:beta-Lactams / Q000009:adverse effects
chemical_list: D003287:Contrast Media; D047090:beta-Lactams
keywords: Anaphylaxis; Contrast media; Drug hypersensitivity; Platinum compounds; Shock