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Accuracy of the diagnosis of allergic reactions in the emergency department
Lacombe-Barrios, J; Gómez, F; Pérez, N; Barrionuevo, E; Doña, I; Fernández Tahía, D; Mayorga, C; Torres, MJ; Moreno, E; Bogas, B; Salas, M.
Afiliação
  • Lacombe-Barrios, J; Málaga University (UMA). Regional University Hospital of Malaga. Allergy Unit. Malaga. Spain
  • Gómez, F; Málaga University (UMA). Regional University Hospital of Malaga. Allergy Unit. Malaga. Spain
  • Pérez, N; Málaga University (UMA). Regional University Hospital of Malaga. Allergy Unit. Malaga. Spain
  • Barrionuevo, E; Málaga University (UMA). Regional University Hospital of Malaga. Allergy Unit. Malaga. Spain
  • Doña, I; Málaga University (UMA). Regional University Hospital of Malaga. Allergy Unit. Malaga. Spain
  • Fernández Tahía, D; Málaga University (UMA). Regional University Hospital of Malaga. Research Laboratory. Malaga. Spain
  • Mayorga, C; Málaga University (UMA). Regional University Hospital of Malaga. Research Laboratory. Malaga. Spain
  • Torres, MJ; Málaga University (UMA). Regional University Hospital of Malaga. Allergy Unit. Malaga. Spain
  • Moreno, E; University Hospital of Salamanca. Allergy Unit. Salamanca. Spain
  • Bogas, B; Málaga University (UMA). Regional University Hospital of Malaga. Allergy Unit. Malaga. Spain
  • Salas, M; Málaga University (UMA). Regional University Hospital of Malaga. Allergy Unit. Malaga. Spain
J. investig. allergol. clin. immunol ; 29(3): 222-230, 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184088
Biblioteca responsável: ES1.1
Localização: BNCS
ABSTRACT

Background:

Suspicion of an acute allergic reaction is a common reason for attending the emergency department (ED). However, there are few comparisons between the initial diagnosis of suspected allergic reaction made in the ED with the definitive diagnosis made subsequently in the allergy department (AD).

Objective:

To compare details of the initial diagnosis made in the ED relating to allergy with the final diagnosis made in the AD.

Methods:

Patients attending the ED of 2 hospitals with suspected allergic reactions were prospectively enrolled based on key words. A certified allergy specialist reviewed the ED records of these patients and, if these were suggestive of an allergic reaction, the patients were scheduled for further evaluation at the allergy clinic.

Results:

In total, 2000 patients were enrolled between April 2013 and October 2015. Of these, 1333 passed the initial assessment and underwent further evaluation. Of the 1333 patients, 528 underwent an allergological study, and 206 were confirmed as being allergic. With respect to drug allergy, nonsteroidal anti-inflammatory drugs were the most common triggers, followed by ß-lactams; in food allergy, plant-based foods were the most common. Only 16.4% of patients confirmed as having anaphylaxis in the AD were initially diagnosed with the condition in the ED.

Conclusion:

Of the 528 patients who finally underwent the full allergological study, fewer than half were confirmed as allergic. Moreover, anaphylaxis appears to be underdiagnosed in the ED. Better communication between the ED and the AD is necessary to improve the diagnosis and management of these patients
RESUMEN
Antecedentes La sospecha de una reacción alérgica aguda es un motivo frecuente de consulta en urgencias. Sin embargo, hay pocos trabajos que comparen el diagnóstico inicial realizado en las unidades de urgencias con el diagnóstico definitivo realizado en las unidades de alergia.

Objetivo:

Analizar en detalle la sospecha diagnóstica inicial dada en urgencias con el diagnóstico definitivo en las consultas de alergia.

Métodos:

Estudio prospectivo, que consistió en la selección, en base a palabras claves, de pacientes con sospecha de reacción alérgica. En la fase de screening, se seleccionaron los pacientes en base a las palabras claves, finalmente aquellos pacientes que presentan reacción sugestiva de alergia se seleccionaron para evaluación final.

Resultados:

Se revisaron 2.000 pacientes entre abril de 2013 y octubre de 2015, de los cuales 1.333 se seleccionaron para la evaluación. Finalmente, 528 se sometieron a un estudio alergológico y 206 se confirmaron como alérgicos. Con respecto a las reacciones por fármacos, los AINE y ß-lactámicos fueron los mayormente implicados; en relación con los alimentos, los de origen vegetal fueron los más frecuentes. Sólo el 16,4% de los pacientes con anafilaxia confirmada tras el estudio de alergia, fueron diagnosticados inicialmente en urgencias.

Conclusión:

Sólo la mitad de los pacientes que finalizaron en estudio fueron confirmados como alérgicos. Un dato importante es el infradiagnóstico de la anafilaxia en las urgencias. Por ello pensamos que es necesaria una mejor comunicación entre las unidades de urgencias y alergia para mejorar el manejo clínico y terapéutico de estos pacientes
Assuntos

Texto completo: Disponível Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Testes Diagnósticos de Rotina / Hipersensibilidade / Anafilaxia Limite: Adulto / Feminino / Humanos / Masculino Idioma: Inglês Revista: J. investig. allergol. clin. immunol Ano de publicação: 2019 Tipo de documento: Artigo Instituição/País de afiliação: Málaga University (UMA)/Spain / University Hospital of Salamanca/Spain

Texto completo: Disponível Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Testes Diagnósticos de Rotina / Hipersensibilidade / Anafilaxia Limite: Adulto / Feminino / Humanos / Masculino Idioma: Inglês Revista: J. investig. allergol. clin. immunol Ano de publicação: 2019 Tipo de documento: Artigo Instituição/País de afiliação: Málaga University (UMA)/Spain / University Hospital of Salamanca/Spain
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