Guidance for diagnosis and treatment of acute angioedema in the emergency department: Consensus statement by a panel of Italian experts

Marco Cicardi, Paolo Bellis, Giuliano Bertazzoni, Mauro Cancian, Maurizio Chiesa, Paolo Cremonesi, Pietro Marino, Nicola Montano, Claudia Morselli, Francesco Ottaviani, Roberto Perricone, Massimo Triggiani, Andrea Zanichelli

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)85-92
Number of pages8
JournalInternal and Emergency Medicine
Volume9
Issue number1
DOIs
Publication statusPublished - Feb 2014

Keywords

  • Acute angioedema
  • C1 inhibitor
  • Consensus statement
  • Emergency management

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine
  • Medicine(all)

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  • Cite this

    Cicardi, M., Bellis, P., Bertazzoni, G., Cancian, M., Chiesa, M., Cremonesi, P., Marino, P., Montano, N., Morselli, C., Ottaviani, F., Perricone, R., Triggiani, M., & Zanichelli, A. (2014). Guidance for diagnosis and treatment of acute angioedema in the emergency department: Consensus statement by a panel of Italian experts. Internal and Emergency Medicine, 9(1), 85-92. https://doi.org/10.1007/s11739-013-0993-z