Clinical Features and Disease Course of Primary Angioedema Patients in a Tertiary Care Hospital
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 Expl...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Dove Medical Press
2020-07-01
|
Series: | Journal of Asthma and Allergy |
Subjects: | |
Online Access: | https://www.dovepress.com/clinical-features-and-disease-course-of-primary-angioedema-patients-in-peer-reviewed-article-JAA |
id |
doaj-124e29e4ddef49779c97ad10115ea2cb |
---|---|
record_format |
Article |
spelling |
doaj-124e29e4ddef49779c97ad10115ea2cb2020-11-25T03:01:47ZengDove Medical PressJournal of Asthma and Allergy1178-69652020-07-01Volume 1322523655411Clinical Features and Disease Course of Primary Angioedema Patients in a Tertiary Care HospitalPall AHLomholt AFvon Buchwald CBygum ARasmussen ERAmalie 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, DenmarkCorrespondence: Amalie Hartvig PallDepartment of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9B, Copenhagen 2100, DenmarkEmail amalie.hartvig.pall.03@regionh.dkPurpose: 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, bradykininhttps://www.dovepress.com/clinical-features-and-disease-course-of-primary-angioedema-patients-in-peer-reviewed-article-JAAprimary angioedemaurticariahereditary angioedemaangiotensin converting enzyme inhibitorsbradykinin |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pall AH Lomholt AF von Buchwald C Bygum A Rasmussen ER |
spellingShingle |
Pall AH Lomholt AF von Buchwald C Bygum A Rasmussen ER Clinical Features and Disease Course of Primary Angioedema Patients in a Tertiary Care Hospital Journal of Asthma and Allergy primary angioedema urticaria hereditary angioedema angiotensin converting enzyme inhibitors bradykinin |
author_facet |
Pall AH Lomholt AF von Buchwald C Bygum A Rasmussen ER |
author_sort |
Pall AH |
title |
Clinical Features and Disease Course of Primary Angioedema Patients in a Tertiary Care Hospital |
title_short |
Clinical Features and Disease Course of Primary Angioedema Patients in a Tertiary Care Hospital |
title_full |
Clinical Features and Disease Course of Primary Angioedema Patients in a Tertiary Care Hospital |
title_fullStr |
Clinical Features and Disease Course of Primary Angioedema Patients in a Tertiary Care Hospital |
title_full_unstemmed |
Clinical Features and Disease Course of Primary Angioedema Patients in a Tertiary Care Hospital |
title_sort |
clinical features and disease course of primary angioedema patients in a tertiary care hospital |
publisher |
Dove Medical Press |
series |
Journal of Asthma and Allergy |
issn |
1178-6965 |
publishDate |
2020-07-01 |
description |
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, DenmarkCorrespondence: Amalie Hartvig PallDepartment of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9B, Copenhagen 2100, DenmarkEmail amalie.hartvig.pall.03@regionh.dkPurpose: 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 |
topic |
primary angioedema urticaria hereditary angioedema angiotensin converting enzyme inhibitors bradykinin |
url |
https://www.dovepress.com/clinical-features-and-disease-course-of-primary-angioedema-patients-in-peer-reviewed-article-JAA |
work_keys_str_mv |
AT pallah clinicalfeaturesanddiseasecourseofprimaryangioedemapatientsinatertiarycarehospital AT lomholtaf clinicalfeaturesanddiseasecourseofprimaryangioedemapatientsinatertiarycarehospital AT vonbuchwaldc clinicalfeaturesanddiseasecourseofprimaryangioedemapatientsinatertiarycarehospital AT byguma clinicalfeaturesanddiseasecourseofprimaryangioedemapatientsinatertiarycarehospital AT rasmussener clinicalfeaturesanddiseasecourseofprimaryangioedemapatientsinatertiarycarehospital |
_version_ |
1724692027774337024 |