Poster: Idiopathic Angioedema: A Subtle Presentation

Research output: Contribution to conferencePoster

Abstract

Idiopathic Allergic Angioedema (AE)  is the most common form and is a diagnosis of exclusion
§ Focal swelling develops rapidly and peak in 5 hours
§ Mostly affects the face while sparing the gastrointestinal and laryngeal mucosa4
§ Ig-E-mediated Type 1 reaction; mast cells release histamine or vasoactive mediators
§ Antihistamine and corticosteroids are the mainstay treatment of idiopathic AE

C1 esterase inhibitor deficiency (C1-INH) is the most common form of hereditary AE 
§ Abnormal complement cascade resulting in unregulated activity of vasoactive mediators bradykinin, kallikreins and plasmin. 
§ Prevalence: 1/10,000 – 100,000.3
§ Bradykinin causes skin, upper respiratory airways and gastrointestinal tract symtpoms
§ Order C1 INH and C4 for patients with family history of AE or suspect C1-INH deficiency
§ Antihistamines, glucocorticosteroids, and epinephrine have little to no effect hereditary AE
§ Treatment of choice is plasma-derived C1-INH concentrate

ACEI AE is a well-documented pharmaceutical side effect that initiates unregulated bradykinin production causing edema in the face, lips, eyelids, tongue, neck and upper airways with airway obstruction dangers. The incidence is highest (25%) within the first month of starting medication but may present years after use.2ACEI AE occurs in less than 1% patients taking ACEI therapy.4 Epinephrine is used for laryngeal edema and anaphylaxis. Definite treatment is the discontinuation of the offending agent. 

Successful AE management requires detection and avoidance of triggers, early recognition of acute attacks, and aggressive airway management. The most common type of AE is idiopathic and responds to antihistamine and corticosteroids. If the patient is not responding to treatment, consider hereditary or medication induced AE. 
Original languageAmerican English
StatePublished - May 2016
EventAmerican Academy of Physician Assistants / 40th Annual Conference - San Antonio, TX
Duration: May 1 2016 → …

Conference

ConferenceAmerican Academy of Physician Assistants / 40th Annual Conference
Period5/1/16 → …

Keywords

  • Angioedema
  • Dermatology
  • ACE Inhibitor

Disciplines

  • Medicine and Health Sciences

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