Anaphylaxis in an emergency department: Epidemiology, clinical features and management

Studies report that anaphylaxis was under-diagnosed in emergency department (ED) and emergency management was often in disagreement with international recommendations.

The aim of this study was to describe the epidemiology, clinical features, management and outcome of patients with anaphylaxis presenting to an ED.

Prospective, observational study over four years (June 2010 to May 2014).

patients (> 14 years of age) presenting consecutively to the ED with the diagnosis of anaphylaxis. Collection of epidemiological, clinical and therapeutic parameters Results: During the study, 239 patients were enrolled. Mean age = 40±15 years. Sex-ratio=0.8.  History of anaphylaxis was reported in 40% of cases. Clinical features n (%): cutaneous features 229 (96), cardiovascular features 124 (52), respiratory features 127 (53), gastrointestinal features 48 (20) and neurologic features 4 (10). Most common allergens: drugs 62%, food 24% and insects 4%. No causes were apparent in 8% of cases. An anaphylactic shock was recorded in 73 patients (31%). Adrenaline was used in 83%of patients, intravenously in 31%.  Corticosteroids and histamine H1 antagonist were prescribed in 98 and 51% respectively. Biphasic reactions were reported in three patients. There was no death cases registered.

Our results showed that the prevalence of anaphylaxis was low.This demonstrates that anaphylaxis is a situation which remains underestimated. It is therefore imperative to conduct prospective multicenter studies in emergency services for better determination of its impact and its risk factors.