ABSTRACT

A clinical vignette illustrates a typical presentation of a patient seeking help for acute angioedema. Despite the risks of SARS-CoV-2 (COVID-19) exposure, it is critical to evaluate patients with acute angioedema in person, because there is always the potential for angioedema to progress to the head, neck, or lungs, which can rapidly compromise the airways and require immediate intervention to avoid potential asphyxiation. There are three mediators of angioedema, histamine, leukotriene, or bradykinin, each requiring different management. This article provides clinicians essential information for differentiating between these types of angioedema, including an overview of the underlying pathogenies of angioedema, and the subjective and objective findings that are useful in differentiating between angioedema types. The article ends with the appropriate management for each type of acute angioedema, including the medications approved by the FDA for on-demand treatment of an HAE attack.

摘要

一个临床小插曲说明了一位患者因急性血管性水肿寻求帮助的典型表现。尽管存在接触 SARS-CoV-2 (COVID-19) 的风险，但亲自评估急性血管性水肿患者至关重要，因为血管性水肿总是有可能发展到头部、颈部或肺部，并可能迅速恶化损害呼吸道并需要立即干预以避免潜在的窒息。血管性水肿有 3 种介质，组胺、白三烯或缓激肽，每种介质都需要不同的管理。本文为临床医生提供了区分这些血管性水肿类型的基本信息，包括血管性水肿潜在病因的概述，以及有助于区分血管性水肿类型的主观和客观发现。