TY - JOUR
T1 - Guidance for diagnosis and treatment of acute angioedema in the emergency department
T2 - Consensus statement by a panel of Italian experts
AU - Cicardi, Marco
AU - Bellis, Paolo
AU - Bertazzoni, Giuliano
AU - Cancian, Mauro
AU - Chiesa, Maurizio
AU - Cremonesi, Paolo
AU - Marino, Pietro
AU - Montano, Nicola
AU - Morselli, Claudia
AU - Ottaviani, Francesco
AU - Perricone, Roberto
AU - Triggiani, Massimo
AU - Zanichelli, Andrea
PY - 2014/2
Y1 - 2014/2
N2 - Angioedema attacks, characterized by the transient swelling of the skin and mucosae, are a frequent cause of visits to the emergency department. Swellings of the oral cavity, tongue, or larynx can result in life-threatening airway obstruction, while abdominal attacks can cause severe pain and often lead to unnecessary surgery. The underlying pathophysiologic process resulting in increased vascular permeability and plasma extravasation is mediated by vasoactive molecules, most commonly histamine and bradykinin. Based on the mediator involved, distinct angioedema forms can be recognized, calling for distinct therapeutic approaches. Prompt recognition is challenging for the emergency physician. The low awareness among physicians of the existence of rare forms of angioedema with different aetiologies and pathogenesis, considerably adds to the problem. Also poorly appreciated by emergency personnel may be the recently introduced bradykinin-targeted treatments. The main objective of this consensus statement is to provide guidance for the management of acute angioedema in the emergency department, from presentation to discharge or hospital admission, with a focus on identifying patients in whom new treatments may prevent invasive intervention.
AB - Angioedema attacks, characterized by the transient swelling of the skin and mucosae, are a frequent cause of visits to the emergency department. Swellings of the oral cavity, tongue, or larynx can result in life-threatening airway obstruction, while abdominal attacks can cause severe pain and often lead to unnecessary surgery. The underlying pathophysiologic process resulting in increased vascular permeability and plasma extravasation is mediated by vasoactive molecules, most commonly histamine and bradykinin. Based on the mediator involved, distinct angioedema forms can be recognized, calling for distinct therapeutic approaches. Prompt recognition is challenging for the emergency physician. The low awareness among physicians of the existence of rare forms of angioedema with different aetiologies and pathogenesis, considerably adds to the problem. Also poorly appreciated by emergency personnel may be the recently introduced bradykinin-targeted treatments. The main objective of this consensus statement is to provide guidance for the management of acute angioedema in the emergency department, from presentation to discharge or hospital admission, with a focus on identifying patients in whom new treatments may prevent invasive intervention.
KW - Acute angioedema
KW - C1 inhibitor
KW - Consensus statement
KW - Emergency management
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U2 - 10.1007/s11739-013-0993-z
DO - 10.1007/s11739-013-0993-z
M3 - Article
C2 - 24002787
AN - SCOPUS:84895058933
VL - 9
SP - 85
EP - 92
JO - Internal and Emergency Medicine
JF - Internal and Emergency Medicine
SN - 1828-0447
IS - 1
ER -