IDIOPATHIC ANAPHYLAXIS - LONG-TERM FOLLOW-UP, COST, AND OUTLOOK

To determine the efficacy of oral corticosteroids, antihistamines, and sympathomimetics in treating patients with idiopathic anaphylaxis, th e charts of 225 patients diagnosed with idiopathic anaphylaxis from 19 71 to 1990 treated at a single center were reviewed. Sixty-one patient s (34 females and 27 males) were available for long-term follow-up. Ag es ranged from 10 to 68 years with an average of 39 years. Patients wi th frequent episodes were treated with a protocol of oral corticostero ids, antihistamines, and sympathomimetics. Patients with infrequent ep isodes were treated for acute episodes only. The number of emergency r oom visits, hospitalizations, intensive care unit admissions, and leng th of time in remission were recorded. Sixty-five percent of patients with infrequent episodes and 91% of patients with frequent episodes of idiopathic anaphylaxis went into remission. Significant decreases in emergency room visits occurred for the idiopathic anaphylaxis-generali zed-frequent group (P < 0.016), the idiopathic anaphylaxis-generalized -infrequent group (P < 0.0001), and the idiopathic anaphylaxis-angioed ema-infrequent group (P < 0.039). Significant decreases in the number of hospitalizations (P < 0.022) and intensive care unit admissions (P < 0.009) occurred for the idiopathic anaphylaxis-generalized-infrequen t and frequent groups, respectively. Overall, an estimated $184 740 wa s saved with the treatment program. for 546 patient-years. Idiopathic anaphylaxis can be controlled and remission induced in most patients. An estimated $11 million per year can be saved for patients in the USA on the basis of the estimated prevalence in this country.