Clinical Approach Used in Medical Consultations for Allergic-Like Events Following Immunization: Case Series Report in Relation to Practice Guidelines.
Identifieur interne : 000080 ( Main/Exploration ); précédent : 000079; suivant : 000081Clinical Approach Used in Medical Consultations for Allergic-Like Events Following Immunization: Case Series Report in Relation to Practice Guidelines.
Auteurs : Joseline G. Zafack [Canada] ; Gaston De Serres [Canada] ; Isabelle Rouleau [Canada] ; Marie-Claude Gariépy [Canada] ; Rémi Gagnon [Canada] ; Jean-Philippe Drolet [Canada] ; Danuta M. Skowronski [Canada]Source :
- The journal of allergy and clinical immunology. In practice [ 2213-2201 ]
Descripteurs français
- KwdFr :
- Adulte (MeSH), Anaphylaxie (épidémiologie), Canada (épidémiologie), Comités consultatifs (MeSH), Enfant (MeSH), Enfant d'âge préscolaire (MeSH), Femelle (MeSH), Guides de bonnes pratiques cliniques comme sujet (MeSH), Humains (MeSH), Hypersensibilité médicamenteuse (épidémiologie), Immunoglobuline E (métabolisme), Mâle (MeSH), Orientation vers un spécialiste (MeSH), Récidive (MeSH), Tests cutanés (MeSH), Vaccination (MeSH), Vaccins (immunologie), Études rétrospectives (MeSH).
- MESH :
- immunologie : Vaccins.
- métabolisme : Immunoglobuline E.
- épidémiologie : Anaphylaxie, Canada, Hypersensibilité médicamenteuse.
- Adulte, Comités consultatifs, Enfant, Enfant d'âge préscolaire, Femelle, Guides de bonnes pratiques cliniques comme sujet, Humains, Mâle, Orientation vers un spécialiste, Récidive, Tests cutanés, Vaccination, Études rétrospectives.
English descriptors
- KwdEn :
- Adult (MeSH), Advisory Committees (MeSH), Anaphylaxis (epidemiology), Canada (epidemiology), Child (MeSH), Child, Preschool (MeSH), Drug Hypersensitivity (epidemiology), Female (MeSH), Humans (MeSH), Immunoglobulin E (metabolism), Male (MeSH), Practice Guidelines as Topic (MeSH), Recurrence (MeSH), Referral and Consultation (MeSH), Retrospective Studies (MeSH), Skin Tests (MeSH), Vaccination (MeSH), Vaccines (immunology).
- MESH :
- chemical , immunology : Vaccines.
- chemical , metabolism : Immunoglobulin E.
- epidemiology : Anaphylaxis, Canada, Drug Hypersensitivity.
- Adult, Advisory Committees, Child, Child, Preschool, Female, Humans, Male, Practice Guidelines as Topic, Recurrence, Referral and Consultation, Retrospective Studies, Skin Tests, Vaccination.
Abstract
BACKGROUND
The Joint Task Force on Practice Parameters (JTFPP) guidelines for the investigation and reimmunization of patients who experienced allergic-like events (ALEs) after immunization are predicated on the likelihood of anaphylaxis, assessed through the time to symptom onset (≤ or >4 hours) and number of systems involved.
OBJECTIVE
The objectives of this study were to compare the management of a series of patients with ALE in actual practice relative to JTFPP guidelines and to discuss key concepts and considerations in their use.
METHODS
This retrospective study was based on a chart review of patients who consulted for suspected vaccine-associated ALEs at a large allergy department in Canada.
RESULTS
Only 3 of the 135 patients who presented ALEs after immunization were referred for suspected anaphylaxis. There was no significant difference in the frequency of skin testing or reimmunization of patients whatever the time to symptom onset or number of systems involved in the ALE. Eight patients whose initial ALE occurred within 1 hour after immunization had a recurrence on reimmunization. Another patient whose initial ALE occurred 10 hours after influenza immunization had throat tightening and difficulty swallowing without objective signs.
CONCLUSIONS
Most ALEs after immunization are not suggestive of anaphylaxis and should not be managed as such. The definition of anaphylaxis in the JTFPP guidelines is nonspecific and may need to be revisited. Restricting skin testing and graded dose reimmunization to patients whose ALE onset is ≤1 hour (compatible with IgE-mediated reaction) and to those meeting specific clinical criteria for anaphylaxis (whatever the timing) is likely a sufficiently sensitive and cautious approach.
DOI: 10.1016/j.jaip.2016.09.048
PubMed: 27914816
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Zafack</name><affiliation wicri:level="4"><nlm:affiliation>Department of Social and Preventive Medicine, Laval University, Québec, QC, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Social and Preventive Medicine, Laval University, Québec, QC</wicri:regionArea><orgName type="university">Université Laval</orgName><placeName><settlement type="city">Québec (ville)</settlement><region type="state">Québec</region></placeName></affiliation></author><author><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><affiliation wicri:level="4"><nlm:affiliation>Department of Social and Preventive Medicine, Laval University, Québec, QC, Canada; Immunity and Infectious Diseases, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada; Biological and Occupational Health, Institut National de Santé Publique du Québec, Québec, Canada. 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Skowronski</name><affiliation wicri:level="1"><nlm:affiliation>Influenza and Emerging Respiratory Pathogens, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Influenza and Emerging Respiratory Pathogens, British Columbia Centre for Disease Control, Vancouver, British Columbia</wicri:regionArea><wicri:noRegion>British Columbia</wicri:noRegion></affiliation></author></analytic><series><title level="j">The journal of allergy and clinical immunology. In practice</title><idno type="eISSN">2213-2201</idno></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Advisory Committees (MeSH)</term><term>Anaphylaxis (epidemiology)</term><term>Canada (epidemiology)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Drug Hypersensitivity (epidemiology)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Immunoglobulin E (metabolism)</term><term>Male (MeSH)</term><term>Practice Guidelines as Topic (MeSH)</term><term>Recurrence (MeSH)</term><term>Referral and Consultation (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Skin Tests (MeSH)</term><term>Vaccination (MeSH)</term><term>Vaccines (immunology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Anaphylaxie (épidémiologie)</term><term>Canada (épidémiologie)</term><term>Comités consultatifs (MeSH)</term><term>Enfant (MeSH)</term><term>Enfant d'âge préscolaire (MeSH)</term><term>Femelle (MeSH)</term><term>Guides de bonnes pratiques cliniques comme sujet (MeSH)</term><term>Humains (MeSH)</term><term>Hypersensibilité médicamenteuse (épidémiologie)</term><term>Immunoglobuline E (métabolisme)</term><term>Mâle (MeSH)</term><term>Orientation vers un spécialiste (MeSH)</term><term>Récidive (MeSH)</term><term>Tests cutanés (MeSH)</term><term>Vaccination (MeSH)</term><term>Vaccins (immunologie)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Vaccines</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Immunoglobulin E</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Anaphylaxis</term><term>Canada</term><term>Drug Hypersensitivity</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Vaccins</term></keywords><keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>Immunoglobuline E</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Anaphylaxie</term><term>Canada</term><term>Hypersensibilité médicamenteuse</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Advisory Committees</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Humans</term><term>Male</term><term>Practice Guidelines as Topic</term><term>Recurrence</term><term>Referral and Consultation</term><term>Retrospective Studies</term><term>Skin Tests</term><term>Vaccination</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Comités consultatifs</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Guides de bonnes pratiques cliniques comme sujet</term><term>Humains</term><term>Mâle</term><term>Orientation vers un spécialiste</term><term>Récidive</term><term>Tests cutanés</term><term>Vaccination</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The Joint Task Force on Practice Parameters (JTFPP) guidelines for the investigation and reimmunization of patients who experienced allergic-like events (ALEs) after immunization are predicated on the likelihood of anaphylaxis, assessed through the time to symptom onset (≤ or >4 hours) and number of systems involved.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>The objectives of this study were to compare the management of a series of patients with ALE in actual practice relative to JTFPP guidelines and to discuss key concepts and considerations in their use.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This retrospective study was based on a chart review of patients who consulted for suspected vaccine-associated ALEs at a large allergy department in Canada.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Only 3 of the 135 patients who presented ALEs after immunization were referred for suspected anaphylaxis. There was no significant difference in the frequency of skin testing or reimmunization of patients whatever the time to symptom onset or number of systems involved in the ALE. Eight patients whose initial ALE occurred within 1 hour after immunization had a recurrence on reimmunization. Another patient whose initial ALE occurred 10 hours after influenza immunization had throat tightening and difficulty swallowing without objective signs.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Most ALEs after immunization are not suggestive of anaphylaxis and should not be managed as such. The definition of anaphylaxis in the JTFPP guidelines is nonspecific and may need to be revisited. Restricting skin testing and graded dose reimmunization to patients whose ALE onset is ≤1 hour (compatible with IgE-mediated reaction) and to those meeting specific clinical criteria for anaphylaxis (whatever the timing) is likely a sufficiently sensitive and cautious approach.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27914816</PMID><DateCompleted><Year>2018</Year><Month>02</Month><Day>26</Day></DateCompleted><DateRevised><Year>2018</Year><Month>02</Month><Day>26</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2213-2201</ISSN><JournalIssue CitedMedium="Internet"><Volume>5</Volume><Issue>3</Issue><PubDate><MedlineDate>2017 May - Jun</MedlineDate></PubDate></JournalIssue><Title>The journal of allergy and clinical immunology. In practice</Title><ISOAbbreviation>J Allergy Clin Immunol Pract</ISOAbbreviation></Journal><ArticleTitle>Clinical Approach Used in Medical Consultations for Allergic-Like Events Following Immunization: Case Series Report in Relation to Practice Guidelines.</ArticleTitle><Pagination><MedlinePgn>718-727.e1</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S2213-2198(16)30546-3</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jaip.2016.09.048</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The Joint Task Force on Practice Parameters (JTFPP) guidelines for the investigation and reimmunization of patients who experienced allergic-like events (ALEs) after immunization are predicated on the likelihood of anaphylaxis, assessed through the time to symptom onset (≤ or >4 hours) and number of systems involved.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">The objectives of this study were to compare the management of a series of patients with ALE in actual practice relative to JTFPP guidelines and to discuss key concepts and considerations in their use.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">This retrospective study was based on a chart review of patients who consulted for suspected vaccine-associated ALEs at a large allergy department in Canada.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Only 3 of the 135 patients who presented ALEs after immunization were referred for suspected anaphylaxis. There was no significant difference in the frequency of skin testing or reimmunization of patients whatever the time to symptom onset or number of systems involved in the ALE. Eight patients whose initial ALE occurred within 1 hour after immunization had a recurrence on reimmunization. Another patient whose initial ALE occurred 10 hours after influenza immunization had throat tightening and difficulty swallowing without objective signs.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Most ALEs after immunization are not suggestive of anaphylaxis and should not be managed as such. The definition of anaphylaxis in the JTFPP guidelines is nonspecific and may need to be revisited. Restricting skin testing and graded dose reimmunization to patients whose ALE onset is ≤1 hour (compatible with IgE-mediated reaction) and to those meeting specific clinical criteria for anaphylaxis (whatever the timing) is likely a sufficiently sensitive and cautious approach.</AbstractText><CopyrightInformation>Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Zafack</LastName><ForeName>Joseline G</ForeName><Initials>JG</Initials><AffiliationInfo><Affiliation>Department of Social and Preventive Medicine, Laval University, Québec, QC, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De Serres</LastName><ForeName>Gaston</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Social and Preventive Medicine, Laval University, Québec, QC, Canada; Immunity and Infectious Diseases, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada; Biological and Occupational Health, Institut National de Santé Publique du Québec, Québec, Canada. Electronic address: gaston.deserres@inspq.qc.ca.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rouleau</LastName><ForeName>Isabelle</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Direction de la Protection de la Santé Publique, Ministère de la Santé et des Services Sociaux du Québec, Montreal, QC, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gariépy</LastName><ForeName>Marie-Claude</ForeName><Initials>MC</Initials><AffiliationInfo><Affiliation>Immunity and Infectious Diseases, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gagnon</LastName><ForeName>Rémi</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Immunity and Infectious Diseases, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Drolet</LastName><ForeName>Jean-Philippe</ForeName><Initials>JP</Initials><AffiliationInfo><Affiliation>Immunity and Infectious Diseases, Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Skowronski</LastName><ForeName>Danuta M</ForeName><Initials>DM</Initials><AffiliationInfo><Affiliation>Influenza and Emerging Respiratory Pathogens, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>11</Month><Day>30</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Allergy Clin Immunol Pract</MedlineTA><NlmUniqueID>101597220</NlmUniqueID></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014612">Vaccines</NameOfSubstance></Chemical><Chemical><RegistryNumber>37341-29-0</RegistryNumber><NameOfSubstance UI="D007073">Immunoglobulin E</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D026683" MajorTopicYN="N">Advisory Committees</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000707" MajorTopicYN="N">Anaphylaxis</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002170" MajorTopicYN="N">Canada</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004342" MajorTopicYN="N">Drug Hypersensitivity</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007073" MajorTopicYN="N">Immunoglobulin E</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017410" MajorTopicYN="N">Practice Guidelines as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012008" 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PubStatus="received"><Year>2016</Year><Month>04</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2016</Year><Month>09</Month><Day>16</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2016</Year><Month>09</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>12</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>2</Month><Day>27</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>12</Month><Day>5</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27914816</ArticleId><ArticleId IdType="pii">S2213-2198(16)30546-3</ArticleId><ArticleId IdType="doi">10.1016/j.jaip.2016.09.048</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li></country><region><li>Québec</li></region><settlement><li>Québec (ville)</li></settlement><orgName><li>Université Laval</li></orgName></list><tree><country name="Canada"><region name="Québec"><name sortKey="Zafack, Joseline G" sort="Zafack, Joseline G" uniqKey="Zafack J" first="Joseline G" last="Zafack">Joseline G. Zafack</name></region><name sortKey="De Serres, Gaston" sort="De Serres, Gaston" uniqKey="De Serres G" first="Gaston" last="De Serres">Gaston De Serres</name><name sortKey="Drolet, Jean Philippe" sort="Drolet, Jean Philippe" uniqKey="Drolet J" first="Jean-Philippe" last="Drolet">Jean-Philippe Drolet</name><name sortKey="Gagnon, Remi" sort="Gagnon, Remi" uniqKey="Gagnon R" first="Rémi" last="Gagnon">Rémi Gagnon</name><name sortKey="Gariepy, Marie Claude" sort="Gariepy, Marie Claude" uniqKey="Gariepy M" first="Marie-Claude" last="Gariépy">Marie-Claude Gariépy</name><name sortKey="Rouleau, Isabelle" sort="Rouleau, Isabelle" uniqKey="Rouleau I" first="Isabelle" last="Rouleau">Isabelle Rouleau</name><name sortKey="Skowronski, Danuta M" sort="Skowronski, Danuta M" uniqKey="Skowronski D" first="Danuta M" last="Skowronski">Danuta M. Skowronski</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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