Anaphylaxis is a rapidly progressing allergic reaction. Adult constitute 83% of the total population of Qatar where no data related to anaphylaxis has been recorded. We sought to describe the clinical presentation, inducers, management and outcomes of these patients.
Data was accumulated over 3 years (July 2014 – July 2017) from the Adult Emergency. Patients were selected using ICD-9 diagnostic codes for allergic reactions, anaphylaxis and food allergy. Cases were classified according to the criteria set by the National Institute of Allergy and Infectious diseases/Food Allergy and Anaphylaxis network for anaphylaxis diagnosis.
A total of 198 cases were identified from 590 cases reviewed. Incidence was 16.5 per 100,000 visits. Mean age was 38 years, 23% were >50 years and females encompassed 78%. Recurrent episodes seen in 20%, biphasic in 4 cases ,15% had pre-diagnosed allergies. Triggers: insect bite 59 % (black ant was 65%), food 19%, medication 8%, idiopathic 14%. Co-morbidity of asthma and eczema was 18% and 7% respectively. In food etiology, seafood was 29%, nuts 10%, chicken 10%, egg 8% and unspecified food 10%.Symptoms included 96% cutaneous, 76%, respiratory , 46%, cardiac, 19% gastrointestinal and 8% neurological .Antihistamines as first line drug were used in 87% and concomitant with adrenaline in 18%. Only 13% were prescribed Epi-pen on discharge and 18% followed up with immunologist.
Emergency department physicians must be educated to use adrenaline as first line treatment and a conscious effort must be made to record the symptoms and triggers conscientiously for a definite diagnosis.