A Case of Refractory Angioedema

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 s...

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Bibliographic Details
Published in:Journal of intensive care medicine 2023-03, Vol.38 (3), p.313-320
Main Authors: Irwin, Thomas M., Longanecker, Andrew, Bodenhamer, William Spence, Keirns, Carla C.
Format: Article
Language:English
Subjects:
Angioedema - etiology
Angioedema - therapy
Angiotensin-Converting Enzyme Inhibitors
Black or African American
Bradykinin - metabolism
Humans
Tracheostomy
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Summary: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.
ISSN:0885-0666
1525-1489
DOI:10.1177/08850666221145310