Edit concept Question Editor Create issue ticket

Intestinal Angioedema


Presentation

  • Patients often present with non-specific findings of abdominal pain, nausea, and vomiting.[radiopaedia.org]
  • It may or may not be pruritic, but when itch is present, it is rarely intense. A burning dysesthesia may be present. Tingling of the area and a slightly numb feeling may precede the onset of obvious swelling.[ncbi.nlm.nih.gov]
  • Whilst HAE often runs in families, genetic changes associated with HAE may appear in a new generation, that were not present in the parents. HAE usually presents in adolescence rather than in infancy, but presentation can also be delayed.[allergy.org.au]
Pain
  • Patients often present with non-specific findings of abdominal pain, nausea, and vomiting.[radiopaedia.org]
  • In more serious cases, angioedema can also cause breathing difficulties, tummy (abdominal) pain and dizziness. Read more about the symptoms of angioedema.[nhs.uk]
  • Liver problems can be recognized by dark urine, stomach pain, yellowing of the skin or the eyes, fatigue, or bruising. *** Angioedema News is strictly a news and information website about the disease.[angioedemanews.com]
  • It is often associated with local burning sensation and pain without pronounced itchiness or local erythema.[emedicine.medscape.com]
Lymphadenopathy
  • CT bowel changes long segment concentric thickening of the bowel submucosa jejunum more often affected mural stratification straightening of bowel loops no obstruction mild mesenteric edema ascites no lymphadenopathy Treatment and prognosis In cases of[radiopaedia.org]
Collapse
  • Dial 999 for an ambulance if you, or someone with you, has swelling and: sudden or worsening breathing problems feels faint or dizzy passes out or collapses These are signs of a serious allergic reaction (anaphylaxis) .[nhs.uk]
Virilization
  • Side effects ranging from weight gain and virilization (or male-like characteristics in women), to menstrual irregularities and headache or depression were reported by in 93 of the 118 patients, and led 30 to stop the treatment.[angioedemanews.com]
Deepening of Voice
  • Other reversible side effects in women include deepening of voice, menstrual irregularities, acne, and hirsutism.[ncbi.nlm.nih.gov]
Abdominal Pain
  • Patients often present with non-specific findings of abdominal pain, nausea, and vomiting.[radiopaedia.org]
  • In more serious cases, angioedema can also cause breathing difficulties, tummy (abdominal) pain and dizziness. Read more about the symptoms of angioedema.[nhs.uk]
  • Hereditary angioedema with recurrent abdominal pain and ascites.[ncbi.nlm.nih.gov]
  • Abdomen: Abdominal pain (sometimes it can be the only presenting symptom of angioedema) Larynx: Throat tightness, voice changes, and breathing trouble (indicators of possible airway involvement), potentially life-threatening.[emedicine.medscape.com]
Vomiting
  • Patients often present with non-specific findings of abdominal pain, nausea, and vomiting.[radiopaedia.org]
  • Thus, sudden abdominal pain, diarrhea, and vomiting in an adult should prompt questioning about recent intake of an ACE inhibitor [ 48, 49 ].[ncbi.nlm.nih.gov]
Nausea
  • Patients often present with non-specific findings of abdominal pain, nausea, and vomiting.[radiopaedia.org]
Angioedema
  • Intestinal angioedema is edema into the submucosal space of the bowel wall following protein extravasation from "leaky" vessels. It can affect both the small and large bowel.[radiopaedia.org]
  • This is known as "idiopathic angioedema". Read more about the causes of angioedema.[nhs.uk]
  • ), or the cause is unknown (idiopathic angioedema).[hrcak.srce.hr]
  • […] were found to have angioedema. [40] Pseudoallergic angioedema “Pseudoallergic” angioedema (PAE) is not mediated by IgE; that is, the angioedema is caused by a nonallergic or nonimmunologic reaction.[emedicine.medscape.com]
  • There are three major patterns of angioedema: Angioedema plus hives (urticaria): the hives itch and the angioedema is itchy, hot or painful. Angioedema alone: itchy, hot and red swellings, often large and uncomfortable.[allergy.org.au]
Fear
  • The initial treatment of patients with most forms of angioedema included administration of antihistamines and glucocorticoids, while epinephrine is given if there is fear from laryngeal edema.[hrcak.srce.hr]
  • Involvement of the mucosae is especially feared, and glossal, pharyngeal, or laryngeal involvement can result in respiratory obstruction, asphyxia, and a fatal outcome.[ncbi.nlm.nih.gov]

Workup

  • Hepatitis B and C virus workup Rheumatoid factor Cryoglobulin levels Imaging studies Imaging studies Most angioedema patients do not need any imaging studies.[emedicine.medscape.com]

Treatment

  • CT bowel changes long segment concentric thickening of the bowel submucosa jejunum more often affected mural stratification straightening of bowel loops no obstruction mild mesenteric edema ascites no lymphadenopathy Treatment and prognosis In cases of[radiopaedia.org]
  • It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.[angioedemanews.com]
  • The treatments recommended depend on the type of angioedema you have.[nhs.uk]
  • See Treatment and Medication for more detail.[emedicine.medscape.com]
  • Treatment Treatment of acquired C1 INH deficiency requires, first, treatment of the underlying disease, if one has been identified, plus treatment with the aforementioned drugs, which is essentially the same as that for treatment of the hereditary disorder[ncbi.nlm.nih.gov]

Prognosis

  • CT bowel changes long segment concentric thickening of the bowel submucosa jejunum more often affected mural stratification straightening of bowel loops no obstruction mild mesenteric edema ascites no lymphadenopathy Treatment and prognosis In cases of[radiopaedia.org]
  • Prognosis The prognosis for patients with angioedema depends on the etiology and varies as follows: Angioedema with identifiable causes – If the trigger(s) can be identified and avoided, angioedema can be prevented Angioedema without identifiable causes[emedicine.medscape.com]

Etiology

  • In addition, supportive care should be provided, regardless of the etiology.[emedicine.medscape.com]
  • No allergic etiology can be found (specifically no reactions to foods or drugs), their health is otherwise normal, complement studies (C4, C1 INH by protein and function) are normal, and there is no familial predisposition.[ncbi.nlm.nih.gov]

Epidemiology

  • Epidemiologic and clinical features of anaphylaxis in Korea. Ann Allergy Asthma Immunol. 2008 Jan. 100(1):31-6. [Medline]. Kalmár L, Hegedüs T, Farkas H, Nagy M, Tordai A.[emedicine.medscape.com]
  • Epidemiology The overall incidence of ACE-induced angioedema is reported to be about 0.1% to 0.2% and is 5 times more common in African Americans than among white patients [ 36 ].[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Angioedema is a result of the fast onset of an increase in local vascular permeability in subcutaneous or submucosal tissue.[emedicine.medscape.com]
  • Pathophysiology The disease was first demonstrated by Virginia Donaldson[ 54 ] to be caused by a defect in the serpin (serine protease inhibitor) C1 INH.[ncbi.nlm.nih.gov]

Prevention

  • Results of a double-blinded clinical trial in nine patients, reported in The New England Journal of Medicine in 1976, evaluated Danocrine’s efficacy in preventing acute hereditary angioedema attacks.[angioedemanews.com]
  • […] antihistamines or occasionally steroid medication to reduce the swelling drug-induced angioedema will usually resolve if you change to a different medication – your doctor will advise you about this hereditary angioedema can't be cured, but medications can help prevent[nhs.uk]
  • Because the likelihood of side effects is greater, other drugs are usually reserved for when antihistamines fail to prevent angioedema, and are generally given under specialist supervision.[allergy.org.au]
  • Mechanism of action of anti-C1-inhibitor autoantibodies: prevention of the formation of stable C1s-C1-inh complexes.[ncbi.nlm.nih.gov]
  • Management The primary goal of medical treatment for angioedema is to reduce and prevent swelling, as well as to reduce discomfort and complication.[emedicine.medscape.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!