Clinical Analysis of Angioedema of the Head and Neck

Lee, Joon Kyoo; Choi, Hyun Seok; Yoon, Tae Mi; Kim, Kag; Seo, Deok Jung; Lim, Sang Chul

Abstract

BACKGROUND AND OBJECTIVES: Angioedema is a localized, nonpitting edema resulting from extravasation of fluid into the interstitial space. It usually develops suddenly and fades during the course of 24 to 48 hours. However, angioedema of the upper respiratory tract can result in serious acute respiratory distress, airway obstruction, and death. The purpose of this study was to analyze clinical characteristics of angioedema in the head and neck.
SUBJECTS AND METHOD
A review of 144 patients with angioedema of the head and neck over 3-year period was conducted.
RESULTS
The presumptive causes were 115 allergic reactions to food, drug, or environmental exposure, 3 losses of C1 esterase inhibitor, 1 angiotensin-converting enzyme inhibitor use, and 25 idiopathic conditions. The main locations of the edema were 100 face/lips, 4 oral cavity/oropharynx, 5 larynx/hypopharynx, and 35 multiple sites of the head and neck. Most of patients were treated with steroids and H1 and H2 blockers. All of 7 patients with low oxygen saturation and 14 out of 18 patients with hypotension on arrival were improved within 24 hours. There were 4 patients with airway distress treated with urgent airway intervention, three of them were completely recovered within 110-240 hours but one of them died of the disease. Patients with the cause of idiopathic and loss of C1 esterase inhibitor were found to stay longer in the hospital over 48 hours (p<0.05).
CONCLUSION
Angioedema of the head and neck usually responds well to the treatment. However, there might be cases with life-threatening airway obstruction.