Angioedema

• Facts:
  Self-limited,localized swelling of the skin or mucosal tissues, which results from extravasation of fluid into the interstitum due to loss of vascular integrity
  
  Mast cell-mediated (urticaria, pruritis)
  Direct mast cell release
  Allergic reactions
  ASA, NSAIDs
  Chronic urticaria w/ or w/o angioedema
  
  Bradykinin mediated (no pruritis, no urticaria)
  ACEIs, ARBs
  Hereditary and acquired angioedema
  Estrogens
  
  Unknown etiologies
  Calcium channel blockers
  Fibrinolytic agents (eg. alteplase)
  
• History / PE:
  Cutaneous edema (face, limbs, genitalia)
  Laryngeal edema
  Abdominal edema(colicky abdominal pain)
• Diagnosis:
  Trypase levels (mast cell mediated) w/i 6-12 hrs of symptom onset
• Treatment:
  Antihistamines, steroids
• Notes:
  
  
• See Also:
  Hereditary and acquired angioedema
  
• Differential Diagnosis:
  Cellulis, erysipelas
  Facial lymphedema
  SVC syndrome
  Blepharochalasis (repeated swelling of eyelids)
  Autoimmune disorders (eg. SLE, lupus)
  Parasitic infections