title: Difficulties encountered in the emergency department by patients with hereditary angioedema experiencing acute attacks.
abstract: BACKGROUND
  Hereditary angioedema (HAE) is a rare, potentially life-threatening disease characterized by recurrent angioedema attacks. Abdominal symptoms of HAE typically mimic numerous abdominal emergencies, which may result in a delay of correct diagnosis and inappropriate treatments.
  
  
  OBJECTIVE
  We aimed to evaluate the difficulties experienced by patients with HAE in Turkish emergency departments (ED).
  
  
  METHODS
  We conducted face-to-face interviews with patients with HAE by using a questionnaire regarding the clinical and demographic data of the patients and difficulties encountered during ED admissions.
  
  
  RESULTS
  The mean (standard deviation) age of 34 patients with HAE (25 women, 9 men) was 36.2 ± 11.5 years and the mean (standard deviation) delay in diagnosis was 17.2 ± 9.7 years. Inappropriate treatment for HAE attacks was administered to 88.2% (n = 30) of patients in the ED, despite their diagnosis of HAE. The most frequent difficulty was "not knowing how to administer C1 inhibitor concentrate" (n = 11 [32.4%]). Other difficulties encountered were as follows: ED staff being unaware of HAE (n = 6 [17.6%]), lack of C1 inhibitor concentrate in the ED (n = 3 [8.8%]), and kept waiting for the appropriate treatment in triage despite their having angioedema in the head-and-neck region (n = 2 [5.9%]).
  
  
  CONCLUSIONS
  Patients with HAE encounter difficulties in the ED, and the delay in diagnosis could be due to a low level of awareness regarding HAE. Therefore, the management of HAE in EDs requires improvement.
authors.affiliation: Department of Clinical Immunology and Allergy, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Ucar
authors.forename: Sevket
authors.initials: S
authors.lastname: Arslan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Baran
authors.forename: Ahmet Zafer
authors.initials: AZ
authors.lastname: Caliskaner
mesh_terms: D000328:Adult; D054179:Angioedemas, Hereditary / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D003422:Critical Care; D057210:Delayed Diagnosis; D004630:Emergencies; D004636:Emergency Service, Hospital; D005260:Female; D019538:Health Care Surveys; D006300:Health Services Misuse; D006801:Humans; D008297:Male; D008875:Middle Aged; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult