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Case Details
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Case Details
Angioedema
Author: Dr. Hasan Altarrah
Published Date: 10/05/2026
Last Modified Date:
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Additional Information:
CC:
swelling lips, +/- abdominal pain and vomiting
Description
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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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