Comparison of the effect of two different intravenousmethylprednisolone doses on the occurrence time ofbiphasic reaction

Abstract

Aim: The aim of this study is to determine the effect of two different doses of methylprednisolone administered in our emergencydepartment (ED) on the elapsed time in biphasic or recurrent anaphylaxis cases. Materials and Methods: The patients with anaphylaxis admitted to the ED were retrospectively analyzed. A total of 82 patientswho received methylprednisolone in combination with epinephrine in the ED due to anaphylaxis and who developed biphasicreaction within 48 h after discharge were included in the study. The patients were classified into two groups according to the doseof methylprednisolone administered: 80 mg (Group 1, low-dose) and 120 mg (Group 2, high-dose). The effect of different doses ofmethylprednisolone on the development time of biphasic reaction was evaluated. Results: Two different doses of IV methylprednisolone administered in the ED did not affect the development time of biphasicreaction (p = 0.24). The biphasic reaction development times were 335 (IQR, 212–950) min in the low-dose group and 520 (IQR, 265– 1150) min in the high-dose group. The earliest development time of biphasic reaction was 125 min (low-dose group) and the latestdevelopment time was 2270 min (high-dose group). The relationship between dose and biphasic reaction development times wasevaluated using Kaplan–Meier curve. No significant difference was observed between the two groups (p = 0.28). Upon comparingthe symptoms in patients’ second admission to the ED due to biphasic reaction, no statistically significant difference was observedin patient symptoms with respect to the dose administered (p > 0.05). Conclusions: Corticosteroids are often used in ED, although there is no definitive evidence that they prevent biphasic reactions. Theadministration of two different doses of methylprednisolone has no effect on biphasic reaction development time.