Angioedema ALSANGEDY

 Swelling of deep dermis, BULLETS™

subcutaneous, or
submucosal tissue due to FOR PACES
vascular leakage FOR EASY PASSING PACES FROM
THE 1ST ATTEMPT
 Acute episodes often involve
Dr. Ibrahim Alsangedy
the lip, eyes, and face MRCP-UK, MRCEM-UK, MRCPE, AMC
CAT (AU), IDHA (USA), M.SC (ICU),
 May affect respiratory and
ADDM, HCQM
gastrointestinal (GI) mucosa
 Laryngeal swelling can be
life-threatening
 Urticaria (hives) may
develop
 Onset is typically over
minutes to hours
 itchy or painful swelling

 In severe cases, stridor of

the airway occurs
 Wheezy chest
 Gasping in severe cases
which may end in complete
cardio-pulmonary arrest
Workup Differential diagnosis Management
 Laboratory Studies  Acute Urticaria  Major goals of therapy
 Anaphylaxis  Airway protection is the
 C4 level  Cellulitis most important
 C1 esterase inhibitor  Delayed Hypersensitivity  Supportive care should be
 Mast cell tryptase levels Reactions provided, regardless of the
may be elevated if the  Drug Allergies etiology
attack was due to  Food Allergies
anaphylactic reaction  Hymenoptera Stings
 Immediate Hypersensitivity
 The stepwise approach
Reactions
 Epinephrine should be used
 Allergy Studies  Latex Allergy
when laryngeal angioedema
 Stinging Insect
 Epicutaneous skin testing is suspected
Hypersensitivity
 Radioallergosorbent tests  Cetirizine is the 1st line
antihistamine
Classification  Chronic cases require
 Radiologic Studies steroid therapy
(1) Hereditary angioedema  In ACE inhibitors induced
 Findings from abdominal (HAE) angioedema the drug needs
radiography and computed to be discontinued and an
Caused by a genetic mutation
tomography (CT) are alternative treatment needs
inherited in an autosomal dominant
consistent with small bowel to be prescribed
form
wall edema during  C1-INH concentrate must
angioedema attacks (2) Acquired angioedema be administered
 Chest x-rays may show (AAE) intravenously in hereditary
pleural effusion angioedema does not
Can be immunologic, non- respond to antihistamines,
 Neck films may show soft-
immunologic, or idiopathic and ACE
tissue swelling steroids, or epinephrine
inhibitors