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Letter to the Editor
Patients with anaphylaxis in accident and emergency are not referred to specialised allergy services
  1. Tariq El-Shanawany1,
  2. Laura Seddon2,
  3. Stephen Jolles1,
  4. Emily Carne1,
  5. Hugo Dowd3,
  6. Paul Williams1
  1. 1Department of Immunology, University Hospital of Wales, Cardiff, UK
  2. 2School of Medicine, Cardiff University, Cardiff, UK
  3. 3Emergency Unit University Hospital Wales, Cardiff, UK
  1. Correspondence to Tariq El-Shanawany, Department of Immunology, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK; tariq.el-shanawany{at}

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Allergy prevalence is reported to be increasing, and anaphylaxis represents the most severe end of the spectrum of allergic disease. UK data show a lifetime prevalence of anaphylaxis of 75.5 per 100 000, similar to epidemiological studies in the USA.1 There are approximately 20 deaths from anaphylaxis per year reported in the UK, although this may be a significant underestimate.2 The Resuscitation Council UK guidelines recommend that ‘All patients presenting with anaphylaxis should be referred to an allergy clinic/service to identify the cause, and thereby reduce the risk of future reactions and prepare the patient to manage future episodes’.3 However, the widespread impression among those providing specialised allergy services is that such patients …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.