National survey on diagnosis and treatment of adult anaphylaxis in Japan: The learning about anaphylaxis in adolescence and adulthood (LANA) survey Part 1.

Background: There have been few epidemiological surveys regarding adult anaphylaxis in Japan. The aim of the study is to investigate the current condition in the diagnosis and management of adult anaphylaxis in Japan.

Methods: An observational, descriptive, cross-sectional study was conducted among physicians who belong to the Japanese Society for Cutaneous Immunology and Allergy and the Japanese Allergology Society, via cloud-based software. A 24-item questionnaire focused on the implementation of diagnostics and management of anaphylaxis, especially in adults.

Results: There were 537 departments that treated anaphylaxis, including 243 pediatrics, 156 dermatology, 124 internal medicine, and 14 allergy departments. Of the group, 362 departments treated adult patients with anaphylaxis, with 149 dermatology being the most common, followed by114 internal medicine, 85 pediatrics and 14 allergy departments. Big prefectures such as Tokyo have the most facilities. However, in terms of population ratio, it became clear that there was not necessarily more coverage in large cities. For anaphylaxis due to foods, specific IgE measurements were the most frequently performed at more than 90 % of all four departments, whereas skin tests and challenge tests were performed less than the IgE measurements at 56.9 % and 35.1 %, respectively. As for the reasons for not performing them, a lack of manpower was mostly cited, followed by lack of preparation for anaphylaxis before testing, unfamiliarity with testing methods, and low or no medical fees.

Conclusions: The survey revealed the uneven geographical distribution of medical departments and the chief barriers for implementation of the examination in adult anaphylaxis.