Angioedema (quick review)

WHAT IS IT?:
--soft tissue swelling, from the release of inflammatory mediators that cause dilation and increased permeability

--affects head/neck commonly (mouth/tongue/throat is bad for airway); bowel wall causing abdominal pain.

--generally develops over minutes to hours and resolves in 24 to 48 hours

CAUSES:

--allergic/mast cell mediated

--hereditary/Deficiency of C1 (complement protein) inhibitor

--drug related (classically ACE inhibitors , but seen with other meds too—e.g. ARBs, NSAIDs, aspirin, calcium channel blockers)

--rare: occurs in only 0.1 to 0.7 percent of patients treated with an ACE inhibitor; half these cases within 1 week of starting the med, but can occur years later;

--38% idiopathic (no trigger identified)

TREATMENT TOOLBOX:

--ABC’s

--stop the drug (if ACE inhibitor related, etc)

--allergic reaction meds: antihistamines, steroids, epinephrine (efficacy not proven, may not work if not mast cell mediated)

--FFP (fresh frozen plasma) a possibility (complement?)

10-SECOND VERSION:

--angioedema: things swell; airway swelling = not awesome

--from allergic reaction, complement deficiency, ACE I's or other drugs, or idiopathic

--treatment options: airway, antihistamines, steroids, epi, FFP

 Reference(s): uptodate.com 'an overview of angioedema'