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Citation-327635803 Ris

Angioedema is a self-limiting condition characterized by localized edema due to increased microvascular permeability, often requiring emergency treatment when it affects the oral cavity or larynx. Diagnosis involves differentiating between histaminergic and non-histaminergic angioedema, with treatment options varying based on the type, including standard therapies for allergic angioedema and specific treatments for C1-inhibitor deficiencies. Immediate clinical diagnosis is crucial, and laboratory tests can confirm the diagnosis later.

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10 views1 page

Citation-327635803 Ris

Angioedema is a self-limiting condition characterized by localized edema due to increased microvascular permeability, often requiring emergency treatment when it affects the oral cavity or larynx. Diagnosis involves differentiating between histaminergic and non-histaminergic angioedema, with treatment options varying based on the type, including standard therapies for allergic angioedema and specific treatments for C1-inhibitor deficiencies. Immediate clinical diagnosis is crucial, and laboratory tests can confirm the diagnosis later.

Uploaded by

ifpd1603
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as TXT, PDF, TXT or read online on Scribd
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TY - JOUR

AU - Depetri, Federica
AU - Tedeschi, Alberto
AU - Cugno, Massimo
PY - 2018/09/01
SP -
N2 - Angioedema is a self-limiting edema of the subcutaneous or submucosal tissues
due to localised increase of microvascular permeability whose mediator may be
histamine or bradykinin. Patients present to emergency department when angioedema
involves oral cavity and larynx (life-threatening conditions) or gut (mimicking an
acute abdomen). After initial evaluation of consciousness and vital signs to manage
breathing and to support circulation if necessary, a simple approach can be applied
for a correct diagnosis and treatment. Forms of edema such as anasarca, myxedema,
superior vena cava syndrome and acute dermatitis should be ruled out. Then, effort
should be done to differentiate histaminergic from non-histaminergic angioedema.
Concomitant urticaria and pruritus suggest a histaminergic origin. Exposure to
allergens and drugs (mainly ACE inhibitors and non steroidal anti-inflammatory
drugs) should be investigated as well as a family history of similar symptoms.
Allergic histaminergic angioedema has a rapid course (minutes) whereas non
histaminergic angioedema is slower (hours). Since frequently the intervention needs
to be immediate, the initial diagnosis is only clinical. However, laboratory tests
can be subsequently confirmatory. Allergic angioedema is sensitive to standard
therapies such as epinephrine, glucocorticoids and antihistamines whereas non
histaminergic angioedema is often resistant to these drugs. Therapeutic options for
angioedema due C1-inhibitor deficiencies are C1-inhibitor concentrates, icatibant
and ecallantide. If these drugs are not available, fresh frozen plasma can be
considered. All these medications have been used also in ACE inhibitor-induced
angioedema with variable results thus they are not currently recommended whereas
experts agree on the discontinuation of the causative drug.
T1 - Angioedema and emergency medicine: From pathophysiology to diagnosis and
treatment
VL - 59
DO - 10.1016/j.ejim.2018.09.004
JO - European Journal of Internal Medicine
ER -

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