D3.345 - Anaphylactic Shock: Clinical Analysis of 8 Cases with Post-Hospital Outpatient Follow-Up

Anaphylactic shock (AS) is a life-threatening systemic hypersensitivity reaction characterized by acute hypotension and/or severe respiratory compromise. Drug- and food-induced anaphylaxis remain leading triggers in adult populations. Early administration of intramuscular epinephrine is the cornerstone of management and significantly improves outcomes. Evaluation of real-world clinical cases allows assessment of trigger distribution, emergency management compliance, and short-term outcomes. 

A retrospective descriptive analysis was conducted of 8 adult patients (age range 18–47 years) who presented for outpatient follow-up after hospital treatment for anaphylactic shock. Variables assessed included: suspected trigger, clinical manifestations, prehospital emergency management, in-hospital treatment, and length of hospitalization.

Quantitative variables are presented as mean (M), standard deviation (SD), median (Me), range (min–max), and 95% confidence interval (95% CI). Categorical variables are expressed as absolute numbers and percentages.

Drug-induced anaphylaxis occurred in 5 patients (62.5%), food-induced in 2 (25%), and the trigger was unidentified in 1 (12.5%). Hypotension was present in all cases (100%). Urticaria occurred in 75%, angioedema in 50%, and bronchospasm in 37.5%. All patients (100%) received intramuscular epinephrine at the prehospital stage, along with corticosteroids and antihistamines. Intravenous fluids were administered in 75%, oxygen therapy in 62.5%, and repeat epinephrine was required in 25%. Mean hospitalization duration was 4.75 ± 1.49 days (median 5; range 3–7; 95% CI 3.5–6.0). No patients required mechanical ventilation, and no fatalities occurred.

Drug-induced reactions represent the leading cause of anaphylactic shock in the studied adult cohort (62.5%). Early recognition and universal administration of intramuscular epinephrine at the prehospital stage were associated with favorable clinical outcomes and absence of severe complications. Outpatient follow-up plays a critical role in secondary prevention, identification of causative allergens, and reduction of recurrent anaphylactic episodes.