Recurrent angioedema: Experience at a tertiary care urban medical center
Abstract Objective To determine the demographics, presentation, management, and outcomes of patients with recurrent angioedema. To compare the findings to patients with ACE inhibitor related angioedema. Methods Retrospective case series with chart review of patients who presented to a tertiary‐care...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-02-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.511 |
| _version_ | 1819051458560000000 |
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| author | Suraj Kedarisetty Derrick Tint Alexander Michael Ahmed M. S. Soliman |
| author_facet | Suraj Kedarisetty Derrick Tint Alexander Michael Ahmed M. S. Soliman |
| author_sort | Suraj Kedarisetty |
| collection | DOAJ |
| description | Abstract Objective To determine the demographics, presentation, management, and outcomes of patients with recurrent angioedema. To compare the findings to patients with ACE inhibitor related angioedema. Methods Retrospective case series with chart review of patients who presented to a tertiary‐care hospital between January 2010 and December 2017 with two or more episodes of angioedema. Excluded were patients with anaphylactic reaction, medication induced angioedema, or angioedema secondary to an infectious etiology. A group of 88 patients who presented during the same time period with ACE inhibitor related angioedema was used as a control. Statistical analysis was conducted using a two‐tailed Fisher exact test and a multivariate logistical regression model to determine significant associations. Results Ninety‐one patients were identified; 61 met the selection criteria and had 217 total episodes of angioedema episodes presenting to the emergency department. Fifty percent were Caucasian or Hispanic. The average number of episodes was 3.5 (range: 2‐23). The lips and tongue were the most commonly affected sites (37% and 39%). The larynx and floor of mouth were least likely to be involved (7% and 6%). Only 1 patient was found to have C1 esterase inhibitor deficiency. Twenty‐eight percent of patients had asthma, allergic rhinitis, food allergies, or atopic dermatitis. Only 11% of episodes required airway intervention. No patients required airway intervention after admission. Conclusion Recurrent angioedema was primarily idiopathic, was less severe than ACE inhibitor angioedema, and was associated with an atopic history. There was less frequent worsening of symptoms after admission, and recurrences occurred more frequently are at the same anatomic subsite. Level of Evidence IV. |
| first_indexed | 2024-12-21T12:04:16Z |
| format | Article |
| id | doaj.art-ed788afa20c1438e94619b722f6f6c7f |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-12-21T12:04:16Z |
| publishDate | 2021-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-ed788afa20c1438e94619b722f6f6c7f2022-12-21T19:04:44ZengWileyLaryngoscope Investigative Otolaryngology2378-80382021-02-0161132010.1002/lio2.511Recurrent angioedema: Experience at a tertiary care urban medical centerSuraj Kedarisetty0Derrick Tint1Alexander Michael2Ahmed M. S. Soliman3Department of Otolaryngology – Head and Neck Surgery Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USADepartment of Otolaryngology – Head and Neck Surgery Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USADepartment of Otolaryngology – Head and Neck Surgery Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USADepartment of Otolaryngology – Head and Neck Surgery Lewis Katz School of Medicine at Temple University Philadelphia Pennsylvania USAAbstract Objective To determine the demographics, presentation, management, and outcomes of patients with recurrent angioedema. To compare the findings to patients with ACE inhibitor related angioedema. Methods Retrospective case series with chart review of patients who presented to a tertiary‐care hospital between January 2010 and December 2017 with two or more episodes of angioedema. Excluded were patients with anaphylactic reaction, medication induced angioedema, or angioedema secondary to an infectious etiology. A group of 88 patients who presented during the same time period with ACE inhibitor related angioedema was used as a control. Statistical analysis was conducted using a two‐tailed Fisher exact test and a multivariate logistical regression model to determine significant associations. Results Ninety‐one patients were identified; 61 met the selection criteria and had 217 total episodes of angioedema episodes presenting to the emergency department. Fifty percent were Caucasian or Hispanic. The average number of episodes was 3.5 (range: 2‐23). The lips and tongue were the most commonly affected sites (37% and 39%). The larynx and floor of mouth were least likely to be involved (7% and 6%). Only 1 patient was found to have C1 esterase inhibitor deficiency. Twenty‐eight percent of patients had asthma, allergic rhinitis, food allergies, or atopic dermatitis. Only 11% of episodes required airway intervention. No patients required airway intervention after admission. Conclusion Recurrent angioedema was primarily idiopathic, was less severe than ACE inhibitor angioedema, and was associated with an atopic history. There was less frequent worsening of symptoms after admission, and recurrences occurred more frequently are at the same anatomic subsite. Level of Evidence IV.https://doi.org/10.1002/lio2.511ACE inhibitorangioedemaC1esterase inhibitorrecurrent angioedema |
| spellingShingle | Suraj Kedarisetty Derrick Tint Alexander Michael Ahmed M. S. Soliman Recurrent angioedema: Experience at a tertiary care urban medical center Laryngoscope Investigative Otolaryngology ACE inhibitor angioedema C1esterase inhibitor recurrent angioedema |
| title | Recurrent angioedema: Experience at a tertiary care urban medical center |
| title_full | Recurrent angioedema: Experience at a tertiary care urban medical center |
| title_fullStr | Recurrent angioedema: Experience at a tertiary care urban medical center |
| title_full_unstemmed | Recurrent angioedema: Experience at a tertiary care urban medical center |
| title_short | Recurrent angioedema: Experience at a tertiary care urban medical center |
| title_sort | recurrent angioedema experience at a tertiary care urban medical center |
| topic | ACE inhibitor angioedema C1esterase inhibitor recurrent angioedema |
| url | https://doi.org/10.1002/lio2.511 |
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