Does severity always increase with successive reactions

It might appear from Table 4.2 that symptoms are constant from one reaction to the next. In general it is true that subjects will have similar reactions if exposed to similar doses in similar situations. It is clear, however, that doses and circumstances vary considerably and therefore reactions can vary considerably too. This is reflected in Table 4.3, which shows how symptoms in the author's Southampton study21 had changed in individuals between the first reaction and the most recent reaction, according to physician review of the reported symptoms. Less than half (41%) of subjects with mild first reactions did not suffer a worse reaction on the most recent exposure. The mild reactors who progressed to more severe reactions were divided almost equally between moderate and severe reactions on the most recent reaction, and 86% of subjects with moderate first reactions suffered a similar or worse reaction on most recent exposure to peanut. Reportedly severe first reactions were predictably stable with 78% suffering a further severe reaction on most recent reaction. Only 9% of severe first reactions were followed by a mild reaction and 13% by a moderate reaction.21

Table 4.3 Comparison of first and most recent reactions to peanut First reaction Most recent reaction

Mild Moderate Severe Total

Mild 44 29 34 107

Moderate 27 111 59 197

Severe 21 29 173 223

Total 92 169 266 527

0 0

Post a comment