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Angiooedema

Angioedema
Synonyms Angiooedema, Quincke's edema, angioneurotic edema
Angioedema2010.JPG
Allergic angioedema: this child is unable to open his eyes due to the swelling.
Specialty Allergy and immunology
Symptoms Area of swelling
Usual onset Minutes to hours
Types Histamine mediated, bradykinin mediated
Risk factors Family history
Diagnostic method Based on symptoms
Similar conditions Anaphylaxis, abscess, contact dermatitis
Treatment Intubation, cricothyroidotomy
Medication Histamine: antihistamines, corticosteroids, epinephrine
Bradykinin: C1 esterase inhibitor, ecallantide, icatibant, fresh frozen plasma
Frequency ~100,000 per year (US)
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Classification
External resources

Angioedema is an area of swelling of the lower layer of skin and tissue just under the skin or mucous membranes. The swelling may occur in the face, tongue, larynx, abdomen, or arms and legs. Often it is associated with hives, which are swelling within the upper skin. Onset is typically over minutes to hours.

The underlying mechanism typically involves histamine or bradykinin. The version related to histamine is to due an allergic reaction to agents such as insect bites, foods, or medications. The version related to bradykinin may occur due to an inherited problem known as C1 esterase inhibitor deficiency, medications known as angiotensin converting enzyme inhibitors, or a lymphoproliferative disorder.

Efforts to protect the airway may include intubation or cricothyroidotomy. Histamine related angioedema can be treated with antihistamines, corticosteroids, and epinephrine. In those with bradykinin related disease a C1 esterase inhibitor, ecallantide, or icatibant may be used.Fresh frozen plasma may be used instead. In the United States the disease affects about 100,000 people a year.


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