Back to Journals » Journal of Asthma and Allergy » Volume 13

Clinical Features and Disease Course of Primary Angioedema Patients in a Tertiary Care Hospital

Authors Pall AH, Lomholt AF, von Buchwald C, Bygum A, Rasmussen ER

Received 8 January 2020

Accepted for publication 5 May 2020

Published 17 July 2020 Volume 2020:13 Pages 225—236

DOI https://doi.org/10.2147/JAA.S245161

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Amrita Dosanjh


Amalie Hartvig Pall,1 Anne Fog Lomholt,1 Christian von Buchwald,1 Anette Bygum,2– 4 Eva Rye Rasmussen1,2

1Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark; 2OPEN – Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; 3Department of Dermatology and Allergy Centre, Odense University Hospital, Odense 5000, Denmark; 4Department of Clinical Research, University of Southern Denmark, Odense 5000, Denmark

Correspondence: Amalie Hartvig Pall
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9B, Copenhagen 2100, Denmark
Email amalie.hartvig.pall.03@regionh.dk

Purpose: To give a better understanding of primary AE, the clinical characteristics and the possible therapeutic approaches.
Background: Angioedema (AE) is a non-pitting, non-itching swelling of skin or mucosa. The symptom can become life-threatening if located in the airways. Primary (monosymptomatic) AE is a manifestation of several different diseases and the diagnosis is not always straight-forward. The aetiological and pathophysiological factors of primary AE are not completely clarified. There is a need for further investigation.
Patients and Methods: This was a retrospective cohort study of patients referred to an outpatient dermatology clinic in a tertiary care hospital for clinical assessment due to primary AE in the period from 1996 to 2014.
Results: A total of 315 patients were identified with primary AE. The most frequent subtype was idiopathic AE (42.5%) and the second most common was angiotensin-converting enzymeinhibitor (ACEi)-induced AE (31.1%). Three patients were diagnosed with hereditary AE and one patient was diagnosed with acquired C1-inhibitor deficiency. At least 107 (34.0%) patients had established histaminergic AE. More than 1/3 of the patients were treated in an emergency room or hospitalized due to AE. A 98.1% of patients had experienced AE in the head and neck area. Seven patients were in the need of acute airway intervention. Six of these had ACEi-induced AE. Female sex and smoking were found to be risk factors for developing AE.
Conclusion: The most frequent diagnoses were histaminergic-, non-histaminergic idiopathic AE and ACEi-induced AE, whereas complement C1-inhibitor deficiency was rare. Histaminergic AE made up a substantial group of patients with primary AE. Even though there are different pathophysiological causes of AE, many cases have overlapping clinical manifestations, which make diagnosis and treatment difficult.

Keywords: primary angioedema, urticaria, hereditary angioedema, angiotensin-converting enzyme inhibitors, bradykinin

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]