Angioedema

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About Angioedema

Angioedema is a potentially life-threatening condition characterized by rapid swelling of deeper skin layers and mucous membranes, most commonly affecting the face, lips, tongue, and throat. It can be hereditary, allergic, or idiopathic in nature, with severe cases causing airway obstruction requiring immediate medical intervention.

Pathophysiology

Angioedema results from increased vascular permeability due to release of vasoactive mediators like histamine, bradykinin, or complement activation. In hereditary angioedema, C1 esterase inhibitor deficiency leads to uncontrolled bradykinin production, while allergic forms involve IgE-mediated mast cell degranulation and histamine release.

Clinical Reasoning

Diagnosis relies on recognizing asymmetric, non-pitting swelling particularly around the eyes, lips, and tongue, often without urticaria in hereditary forms. Immediate assessment focuses on airway patency and breathing adequacy, as laryngeal involvement can rapidly progress to complete obstruction requiring emergent intubation or surgical airway management.

References

  1. Angioedema. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK538489/
  2. WAO/EAACI Angioedema Guidelines. WAO J 2022. https://doi.org/10.1186/s40413-021-00375-9
  3. WAO/EAACI Guideline for Hereditary Angioedema. WAO Journal. https://doi.org/10.1186/s40413-022-00540-4
  4. Angioedema Practice Parameter. JACI: In Practice. https://doi.org/10.1016/j.jaip.2021.12.013

Related Topics

AnaphylaxisHereditary AngioedemaHereditary AngioedemaChronic UrticariaAllergic Rhinitis