Clinical Case Database / Category: Patient Management

Angioedema - case-based discussion

Publication details

E Staples, K Hopkinson, E Drewe
Foundation Years Journal, volume 8, issue 4, p.54 (123Doc Education, London, April 2014)

Abstract

Recurrent angioedema, due to oedema of subcutaneous tissue, may present to primary or secondary care. Laryngeal angioedema can be life-threatening. Causes include idiopathic or spontaneous angioedema (with or without urticaria), drugs including angiotensin converting enzyme inhibitors (ACE-I), allergy, and rarely C1 inhibitor deficiency. Salient features in the history can help to determine aetiology facilitating appropriate treatment.

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Authors

E Staples

Specialist Registrar
Clinical Immunology and Allergy
Nottingham University Hospitals NHS Trust
Queen’s Medical Centre Campus
Derby Road
Nottingham
NG7 2UH
Emily.staples@nuh.nhs.uk

K Hopkinson

Clinical Nurse Specialist
Clinical Immunology and Allergy
Nottingham University Hospitals NHS Trust
Queen’s Medical Centre Campus
Derby Road
Nottingham
NG7 2UH

E Drewe

Consultant
Clinical Immunology and Allergy
Nottingham University Hospitals NHS Trust
Queen’s Medical Centre Campus
Derby Road
Nottingham
NG7 2UH

References

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2. Brown NJ, Snowden M, Griffin MR. Recurrent angiotensin-converting enzyme inhibitor associated angioedema. JAMA. 1997;278(3):232-3.
3. Dean DE, Schultz DL, Powers RH. Asphyxia due to angiotensin converting enzyme (ACE) inhibitor mediated angioedema of the tongue during the treatment of hypertensive heart disease. J Forensic Sci. 2001 Sep;46(5):1239-43.
4. Nussberger J, Cugno M, Amstutz C, Cicardi M, Pellacani A, Agostoni A. Plasma bradykinin in angiooedema. Lancet. 1998 Jun 6;351(9117):1693-7.
5. Molinaro G, Cugno M, Perez Ml, Lepage Y, Gervais N, Agostoni A, et al. Angiotensin-Converting Enzyme Inhibitor-Associated Angioedema Is Characterized by a Slower Degradation of des-Arginine9- Bradykinin. Journal of Pharmacology and Experimental Therapeutics. 2002 October 1, 2002;303(1):232-7.
6. Bas M, Greve J, Stelter K, Bier H, Stark T, Hoffmann TK, et al. Therapeutic Efficacy of Icatibant in Angioedema Induced by Angiotensin-Converting Enzyme Inhibitors: A Case Series. Annals of Emergency Medicine. 2010;56(3):278-82.
7. Resuscitation_Council U. Emergency treatment of anaphylactic reactions. 2012 [cited 4th July
2013]; Available from: http://www.resus.org.uk/pages/reaction.htm
8. Powell RJ, Du Toit GL, Siddique N, Leech SC, Dixon TA, Clark AT, et al. BSACI guidelines for the management of chronic urticaria and angio-oedema. Clinical & Experimental Allergy. 2007;37(5):631- 50.
9. Gompels MM, Lock RJ, Abinun M, Bethune CA, Davies G, Grattan C, et al. C1 inhibitor deficiency: consensus document. Clin Exp Immunol. 2005;139(3):379-94.

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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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