A Case of Refractory Angioedema. (March 2023)

• Record Type: Journal Article
• Authors: Irwin, Thomas M.; Irwin, Thomas M.; Longanecker, Andrew; Bodenhamer, William Spence; Keirns, Carla C.
• Is Part Of: Journal of intensive care medicine. Volume 38:Number 3(2023)
• Page Start: 313
• Page End: 320
• Publication Date: 2023-03
• Subjects: angioedema -- refractory -- airway -- trachea; Critical care medicine -- Periodicals; Critical Care -- Periodicals; Soins intensifs -- Périodiques; Soins intensifs; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.02805
• DOI: 10.1177/08850666221145310
• Languages: English
• ISSNs: 0885-0666

Abstract

Angioedema is an acute disorder that affects mucous membranes and the deepest layers of the skin along with underlying tissue, marked by rapid swelling, large welts, and pain. There are 3 major subtypes of angioedema: mast-cell mediated, bradykinin-mediated, and multifactorial or unclear mechanism subtype. The most common subtype of bradykinin-mediated angioedema is ACE-inhibitor induced, which disproportionately affects African-Americans. It is most often self-limiting and usually responds to the withdrawal of the offending agent. The prolonged duration of angioedema is uncommon in the absence of a persistent stimulus, though it is more likely when there is an abnormality of the metabolic pathways, such as in hereditary angioedema or other gene polymorphisms affecting the complement system. We present a case of severe angioedema that persisted for over a month and required a tracheostomy to manage the airway.