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Case Details

Angioedema

  • Author: Dr. Hasan Altarrah
  • Published Date: 10/05/2026
  • Last Modified Date:
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  • Reviews: ( 0 Reviews )
  • Category :Internal Medicine
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Additional Information:

  • CC: swelling lips, +/- abdominal pain and vomiting

Description

Causes
1. Mast Cell Mediated
  • Associated with urticaria, bronchospasm or hypotension

Examples

  • Allergic reactions (peanuts, shrimp, latex, insect stings)
  • Direct mast cell stimulation (NSAIDs, radiocontrast media, opioids)
2. Bradykinin Mediated
  • No urticaria or pruritis

Examples

  • ACE inhibitors
  • DPP-4 inhibitors (gliptins)
  • Hereditary and acquired angioedema due to C1 inhibitor deficiency
  • Acquired C1 inhibitor deficiency associated with SLE, lymphoma or MGUS
  • Hereditary angioedema with normal C1 inhibitor
3. Idiopathic Angioedema
  • No identifiable underlying cause
What Will You Do?
  • Check vitals and remember Circulation, Airway and Breathing (CAB)
  • Antihistamine, epinephrine and steroid
  • Call ICU
  • Basic labs like CBC, RFT and LFT
  • ENT consult
  • Do C4 and C1-inhibitor levels
  • Stop offending drugs such as ACE inhibitors
  • For hereditary angioedema:
    • C1 inhibitor concentrate
    • If unavailable, use fresh frozen plasma (FFP)
    • Other drugs: Ecallantide & Icatibant
Remember
  • In patients with urticaria and angioedema, do not diagnose hereditary angioedema

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