subcutaneous, or submucosal tissue due to FOR PACES vascular leakage FOR EASY PASSING PACES FROM THE 1ST ATTEMPT Acute episodes often involve Dr. Ibrahim Alsangedy the lip, eyes, and face MRCP-UK, MRCEM-UK, MRCPE, AMC CAT (AU), IDHA (USA), M.SC (ICU), May affect respiratory and ADDM, HCQM gastrointestinal (GI) mucosa Laryngeal swelling can be life-threatening Urticaria (hives) may develop Onset is typically over minutes to hours itchy or painful swelling
In severe cases, stridor of
the airway occurs Wheezy chest Gasping in severe cases which may end in complete cardio-pulmonary arrest Workup Differential diagnosis Management Laboratory Studies Acute Urticaria Major goals of therapy Anaphylaxis Airway protection is the C4 level Cellulitis most important C1 esterase inhibitor Delayed Hypersensitivity Supportive care should be Mast cell tryptase levels Reactions provided, regardless of the may be elevated if the Drug Allergies etiology attack was due to Food Allergies anaphylactic reaction Hymenoptera Stings Immediate Hypersensitivity The stepwise approach Reactions Epinephrine should be used Allergy Studies Latex Allergy when laryngeal angioedema Stinging Insect Epicutaneous skin testing is suspected Hypersensitivity Radioallergosorbent tests Cetirizine is the 1st line antihistamine Classification Chronic cases require Radiologic Studies steroid therapy (1) Hereditary angioedema In ACE inhibitors induced Findings from abdominal (HAE) angioedema the drug needs radiography and computed to be discontinued and an Caused by a genetic mutation tomography (CT) are alternative treatment needs inherited in an autosomal dominant consistent with small bowel to be prescribed form wall edema during C1-INH concentrate must angioedema attacks (2) Acquired angioedema be administered Chest x-rays may show (AAE) intravenously in hereditary pleural effusion angioedema does not Can be immunologic, non- respond to antihistamines, Neck films may show soft- immunologic, or idiopathic and ACE tissue swelling steroids, or epinephrine inhibitors