509:
Incidence, Etiology and characteristics of adult onset anaphylaxis in Qatar
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Mehdi Adeli, MD, Khalid Alyafei, Sohaib Imtiaz Chaudhry, Sabha Nisar
RATIONALE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.