Angioedema, Emergency Medicine

Sean-Xavier Neath Reviewed 06/2017
 


Basics

Description

  • Nonpruritic, well-demarcated, nonpitting edema of the dermis

  • Due to the release of inflammatory mediators that cause dilation and increased permeability of capillaries and venules:

    • Mas...

Diagnosis

Signs and Symptoms

History

  • A family history or history of recurrent episodes can be useful in the diagnosis. Use of culprit foodstuffs or medications, especially ACEIs should increase index of...

Treatment

Pre-Hospital

  • Establish IV access

  • Early intubation may be necessary due to the rapid progression of laryngeal swelling.

  • Administration of H1 blocker when available

  • Epinephrine to be considered fo...

Follow-Up

Disposition

Admission Criteria

  • Patients with systemic symptoms that do not resolve completely will need to be hospitalized for observation.

  • A monitored bed is recommended for those with airway ...

Pearls and Pitfalls

  • Early measures should be employed to maintain the patient's airway.

  • Consider use of newer agents in HAE patients (e.g., C1-INH and Kallikrein inhibition).

Additional Reading

  • Austen  K. Allergies, anaphylaxis, and systemic mastocytosis. In: Fauci  AS, Braunwald  E, Kasper  DL, et al., eds. Harrison's Principles of Internal Medicine, 17th ed. New York, N...

Codes

ICD9

  • 277.6 Other deficiencies of circulating enzymes

  • 995.1 Angioneurotic edema, not elsewhere classified

ICD10

  • D84.1 Defects in the complement system

  • T78.3XXA Angioneurotic edema, initial encounter

SNOMED

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