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Review
. 2023 Feb;118(1):4-13.
doi: 10.1007/s00063-022-00983-9. Epub 2022 Dec 29.

[Angioedema in the emergency department]

[Article in German]
Laura Bühler  1 , Bonaventura Schmid  2 , Elisabeth Fabritius  3 , Tanja Daniela Grauvogel  3
Affiliations
Review

[Angioedema in the emergency department]

[Article in German]
Laura Bühler et al. Med Klin Intensivmed Notfmed. 2023 Feb.

Abstract
in English, German

Acute angioedema is mostly found in the head and neck region. Therefore, it can be life threatening by potentially endangering air way patency. Pathophysiologically angioedemas can be divided into mast cell-mediated or bradykinin-mediated forms. Differentiation is essential due to the different therapeutic strategies. In cases of doubt, initial therapy with adrenalin, antihistamines, and glucocorticoids should be initiated. This initial emergency treatment is comparable to the treatment of allergic reactions. For diagnosed or suspected hereditary angioedema, specific treatments are available. For drug-associated forms, immediate and life-long cessation of the medication is crucial. In the emergency situation, diagnosis can only be based on medical history and clinical symptoms. Recognition of impending airway obstruction and securing the airway is of highest priority; final diagnosis must be confirmed later.

Akute Angioödeme können potenziell lebensbedrohlich verlaufen. Die vor allem im Kopf-Hals-Bereich auftretenden Schwellungen können in mastzellmediatorvermittelte und bradykininvermittelte Formen unterteilt werden. Die Unterscheidung ist aufgrund der unterschiedlichen therapeutischen Strategien essenziell, wobei im Zweifelsfall immer ein Therapieversuch mit Adrenalin, Antihistaminika und Glukokortikoiden durchgeführt werden sollte. Für die hereditären Angioödeme existiert eine spezifische Therapie, bei medikamentenassoziierten Formen ist der umgehende und lebenslange Stopp der Medikation entscheidend. In der Notfallsituation kann die Diagnose ausschließlich aufgrund von Anamnese und klinischen Symptomen gestellt werden. Die Erkennung einer drohenden Atemwegsverlegung und die Sicherung des Atemwegs hat die höchste Priorität.

Keywords: Allergic reaction; Bradykinin receptor; C1 esterase inhibitor; Emergency medicine; Mast cells.

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References

Literatur

    1. Moellman JJ, Bernstein JA, Lindsell C, Banerji A, Busse PJ, Camargo CA et al (2014) A consensus parameter for the evaluation and management of angioedema in the emergency department. Acad Emerg Med 21(4):469–484 - DOI
    1. LoVerde D, Files DC, Krishnaswamy G (2017) Angioedema. Crit Care Med 45(4):725–735 - DOI
    1. Ring J, Beyer K, Biedermann T, Bircher A, Fischer M, Fuchs T et al (2021) Guideline (S2k) on acute therapy and management of anaphylaxis: 2021 update. Allergo J Int 30(1):1–25 - DOI
    1. Bork K (2014) Angioedema. Immunol Allergy Clin North Am 34(1):23–31 - DOI
    1. Bork K, Meng G, Staubach P, Hardt J (2006) Hereditary angioedema: new findings concerning symptoms, affected organs, and course. Am J Med 119(3):267–274 - DOI

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