title: Underdiagnosis of anaphylaxis in the emergency department: misdiagnosed or miscoded?
abstract: OBJECTIVE
  To distinguish allergic reactions and anaphylaxis, and to highlight the importance of anaphylaxis.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Adult emergency department of the medical faculty of Hacettepe University, Ankara, Turkey.
  
  
  METHODS
  Adults admitted to the emergency department between 1 May 2005 and 30 April 2010 with allergic diseases considered to be anaphylaxis or anaphylactic reactions.
  
  
  METHODS
  Patient age, gender, possible cause(s) of allergy, organ involvement, treatment, and physical examination findings.
  
  
  RESULTS
  Although recorded physical examination findings of patients were consistent with anaphylaxis, 88 patients were not diagnosed as having this condition. All patients in this study group were evaluated in the emergency department facility and did not consult or were not referred to any other department or specialist. In all, 79 (90%) of them were discharged in the first 12 hours, 5 (6%) after 12 to 24 hours, and 4 (5%) after 24 hours. None of these patients died.
  
  
  CONCLUSIONS
  Emergency physicians should be better able to recognise the clinical features of anaphylaxis, so as to treat the episode promptly and appropriately. Delay in diagnoses could lead to incomplete treatment and even be fatal.
authors.affiliation: Department of Emergency Medicine, Dr Lutfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Hocagil
authors.forename: E
authors.initials: E
authors.lastname: Karakilic
authors.forename: C
authors.initials: C
authors.lastname: Hocagil
authors.forename: H
authors.initials: H
authors.lastname: Senlikci
authors.forename: F
authors.initials: F
authors.lastname: Buyukcam
mesh_terms: D000293:Adolescent; D000328:Adult; D000707:Anaphylaxis / Q000175:diagnosis* / Q000503:physiopathology; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D004635:Emergency Medicine / Q000592:standards; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
keywords: Anaphylaxis; Diagnosis; Emergency service, hospital