• Margitta Worm, Oliver Eckermann, Sabine Dölle, Werner Aberer, Kirsten Beyer, Thomas Hawranek, Stephanie Hompes, Alice Koehli, Vera Mahler, Katja Nemat, Bodo Niggemann, Claudia Pföhler, Uta Rabe, Angelika Reissig, Ernst Rietschel, Kathrin Scherer, Regina Treudler, and Franziska Ruëff.
• Allergy Center Charité, Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, ADAC Air Rescue Service Senftenberg, Department of Dermatology and Venereology, Medical University of Graz, Austria, Department of Pediatrics, Pneumonology and Immunology, Charité - Universitätsmedizin Berlin, Allergy Clinic, Department of Dermatology, SALK, Paracelsus Medical University, Salzburg, Austria, Pediatric Allergology, University Children's Hospital Zurich, Zurich, Switzerland, Department of Dermatology, University Hospital Erlangen-Nürnberg, Department of Pediatric Pneumology and Allergology at the KID Center, Dresden-Friedrichstadt, Department of Dermatology, Venerology and Allergy at the Saarland University, Homburg/Saar, Department of Allergology, Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH, Treuenbrietzen, Department of Internal Medicine I: Pneumology & Allergology/Immunology, Friedrich Schiller University Jena, Department of Pediatric Pulmonology and Allergology, Children's Hospital of the University of Cologne, Allergy Unit, Department of Dermatology, University Hospital Basel, Basel, Schweiz, Department of Dermatology, Venereology and Allergology, University of Leipzig, Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Margitta Worm and Oliver Eckermann have equally contributed to the manuscript.
• Dtsch Arztebl Int. 2014 May 23; 111 (21): 367375367-75.

BackgroundAnaphylaxis is the most severe manifestation of a mast cell-dependent immediate reaction and may be fatal. According to data from the Berlin region, its incidence is 2-3 cases per 100 000 persons per year.MethodWe evaluated data from the anaphylaxis registry of the German-speaking countries for 2006-2013 and data from the protocols of the ADAC air rescue service for 2010-2011 to study the triggers, clinical manifestations, and treatment of anaphylaxis.ResultsThe registry contained data on 4141 patients, and the ADAC air rescue protocols concerned 1123 patients. In the registry, the most common triggers for anaphylaxis were insect venom (n = 2074; 50.1%), foods (n = 1039; 25.1%), and drugs (n = 627; 15.1%). Within these groups, the most common triggers were wasp (n = 1460) and bee stings (n = 412), legumes (n = 241), animal proteins (n = 225), and analgesic drugs (n = 277). Food anaphylaxis was most frequently induced by peanuts, cow milk, and hen's egg in children and by wheat and shellfish in adults. An analysis of the medical emergency cases revealed that epinephrine was given for grade 3 or 4 anaphylaxis to 14.5% and 43.9% (respectively) of the patients in the anaphylaxis registry and to 19% and 78% of the patients in the air rescue protocols.ConclusionWasp and bee venom, legumes, animal proteins, and analgesic drugs were the commonest triggers of anaphylaxis. Their relative frequency was age-dependent. Epinephrine was given too rarely, as it is recommended in the guidelines for all cases of grade 2 and above.

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