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 inJournal of intensive care medicine Vol. 38; no. 3; p. 313
Main Authors Irwin, 3rd, Thomas M, Irwin, Jr, Thomas M, Longanecker, Andrew, Bodenhamer, William Spence, Keirns, Carla C
Format Journal Article
LanguageEnglish
Published United States 01.03.2023
Subjects
Angioedema - etiology
Angioedema - therapy
Angiotensin-Converting Enzyme Inhibitors
Black or African American
Bradykinin - metabolism
Humans
Tracheostomy
angioedema
refractory
trachea
airway
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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:1525-1489
DOI:10.1177/08850666221145310