title: The Etiology and Clinical Features of Anaphylaxis in a developing country: A nationwide survey in Turkey.
abstract: BACKGROUND
  Despite the increasing frequency of anaphylaxis, there is inadequate information on the etiology and clinical features in various countries, regions and age groups, especially in developing countries.
  
  
  OBJECTIVE
  Our aim is to assess the etiology and clinical findings of anaphylaxis in Turkey. Gathering reliable data about the etiology and clinical findings of anaphylaxis in the general population will decrease the related morbidity and mortality.
  
  
  METHODS
  We obtained the names and phone numbers of individuals who had been prescribed an epinephrine auto-injector with a diagnosis of anaphylaxis from ministry of health. Demographic data, clinical history of the first episode of anaphylaxis including the triggering agent, clinical findings, course of hospitalization, and the management of anaphylaxis were obtained by phone survey.
  
  
  RESULTS
  A total of 843 patients with a mean age of 21.4±17.3 years were evaluated. There was a significant male predominance among children younger than 10 years of age but a female predominance in older subjects. The most common causes of anaphylaxis were foods(40.1%) in children and bee venom(60.8%) in adults. The biphasic reaction rate was 4.3% and the median length of stay at an emergency department was 4.0 hours. Almost 60% of the patients had recurrent anaphylaxis episodes. Only 10.7% of the cases were prescribed an epinephrine auto-injector at their first anaphylaxis episode and only 59.2% of the patients were referred to an allergist during discharge from the emergency department.
  
  
  CONCLUSIONS
  In Turkey, bee venom was the most common cause of anaphylaxis, followed by food and drug. While more than a half of patients reported recurrent attacks; only 10% had been prescribed epinephrine auto-injector kit after their first episode. Strategies to improve the anaphyalxis management are therefore urgently required.
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: Ersoy
authors.initials: E
authors.lastname: Civelek
authors.affiliation: Abant Izzet Baysal University, Faculty of Medicine, Department of Pediatric Allergy and Immunology, Bolu, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Erkoçoğlu
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Akan
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: Celal
authors.initials: C
authors.lastname: Özcan
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: Ayşenur
authors.initials: A
authors.lastname: Kaya
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Vezir
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: Tayfur
authors.initials: T
authors.lastname: Giniş
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Azkur
authors.affiliation: Ankara Pediatric and Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.
authors.forename: Müge
authors.initials: M
authors.lastname: Toyran
authors.affiliation: Abant Izzet Baysal University, Faculty of Medicine, Department of Pediatric Allergy and Immunology, Bolu, Turkey.|Ministry of Health of Turkey General Directorate of Pharmaceuticals and Pharmacy.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Tokaç
authors.affiliation: Mugla Sitki Kocman University, Faculty of Medicine, Department of Pediatric Allergy and Immunology.
authors.forename: Can Naci
authors.initials: CN
authors.lastname: Kocabaş
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology; D000707:Anaphylaxis / Q000453:epidemiology* / Q000276:immunology; D000818:Animals; D001514:Bee Venoms / Q000276:immunology; D001516:Bees / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005502:Food / Q000009:adverse effects; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000485:Allergens; D001514:Bee Venoms; D004837:Epinephrine