Recognition and Differential Diagnosis of Hereditary Angioedema in the Emergency Department

BackgroundAngioedema (AE) is a clinical syndrome marked by localized swelling of the subcutaneous layer skin or submucosal respiratory gastrointestinal tracts. While AE commonly mediated histamine (allergic AE), some types result from excessive bradykinin activity, including hereditary (HAE), acquired AE, and angiotensin-converting enzyme inhibitor–induced AE. These are less common but important to consider given different treatment requirements potentially serious outcomes, death laryngeal swelling.ObjectiveThis review describes pathophysiology features as well diagnosis in emergency department (ED).DiscussionBradykinin-mediated does not respond antihistamines corticosteroids. By contrast, several targeted, effective therapies available, C1-inhibitor (C1-INH) concentrates, which replace missing protein activity underlying bradykinin-mediated medications that directly lessen (eg, ecallantide icatibant). Urticaria generally absent serves primary differentiating factor diagnosis. Relevant laboratory assessments may include C1-INH levels, function, C4 complement. Patients with HAE family member can communicate their known when presenting ED, even bring own medication(s) them. newly diagnosed ED should be referred for specialized outpatient care upon discharge.ConclusionsThere great need clinicians aware HAE, its differential diagnosis, appropriate ensure patients receive optimal timely treatment.