Angioedema is a localized, sudden, transient, and often recurrent swelling of the deeper layers of the skin or mucosa with no epidermal component. It is caused by vasoactive substances that produce a transient increase in endothelial permeability. Angioedema involving the laryngeal components is a life-threatening situation for the patient, and it is a challenge for the emergency medicine physician to rapidly achieve a safety airway. Most cases of laryngeal angioedema are induced by histamine release; but 10% are bradykinin induced, which does not respond to the conventional algorithm of treating allergicinduced angioedema. We present a case report of an angiotensinconverting enzyme (ACE) inhibitor-induced laryngeal angioedema alleviated only after treatment with the new bradykinin receptor inhibitormedication icatibant which was licensed only for use in hereditary angioedema. We reviewed the literature for the use of icatibant in acquired drug-induced angioedema; and because of the similar pathogenesis between the hereditary angioedema and the ACE inhibitor- induced angioedema,we propose an algorithmfor careful use of icatibant in life-threatening angioedema in the emergency department.
|Journal||American Journal of Emergency Medicine|
|State||Published - 1 Jan 2015|
ASJC Scopus subject areas
- Emergency Medicine