Acute angioedema – retrospective analysis of diagnosis, course of disease and therapy

Introduction:

Acute angioedema (AE) can cause life-threatening obstructions when occurring in the upper airway. An useful classification for clinical practice based on its triggering mediators histamine and bradykinin is crucial for choosing the right therapy and for the further course of disease.

Methods:

Patients presenting with acute AE at the ENT University Hospital of Ulm within a period of 6 years were included (247 cases). We analyzed angioedema cause, localization, temporal occurrence, course of disease and therapy.

Results:

The most common triggers were drugs (RAE) and histamine-mediation (HisAE). Hereditary AE (HAE) were rare. Swelling was mainly localized in the oral cavity. RAE often get inpatient and HAE outpatient treatment. The mean duration of symptoms/inpatient stay was extended for RAE. In 86% an antiallergic therapy was performed. Most HAE received a bradykinin-specific therapy. Only 4% showed critical developments with necessity of intubation/tracheostomy. Therefore, specific risk was higher for RAE and swelling in the oral cavity. RAE were treated with bradykinin-specific drugs only in protracted course and lacking response to antiallergic therapy.

Conclusion:

In case of acute life-threatening swellings a rapid diagnosis of the appropriate angioedema cause is important for initiating a targeted therapy. Especially in RAE we could attenuate the course of disease and avoid critical developments by using specific drugs.

Publication History

Publication Date:
18 April 2018 (online)