Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Angioedema urticaria [keywords]
- Adverse reaction to silicone simulating orofacial granulomatosis. [JOURNAL ARTICLE]
- J Eur Acad Dermatol Venereol 2014 Apr 21.
Granulomatous reactions to silicone facial fillers are well described in the literature. Clinically, these reactions present as nodules or pseudotumors that are frequently described as silicone granulomas or siliconomas.We want to report a peculiar form of granulomatous reaction to injected silicone characterized by recurrent episodes of facial edema.We collected silicone infiltrated patients with a similar clinical picture consisting of asymptomatic episodes of unilateral facial edema that had been recurring for months or years.We found four women with recurrent episodes of facial edema. They had been infiltrated with silicone in the face. Histology showed silicone deposits and a granulomatous infiltrate in all 4 cases.We describe and illustrate a new type of adverse reaction to injected silicone simulating orofacial granulomatosis. The reaction presents as recurrent, unilateral, asymmetric facial edema of the cheek in patients who have been injected with silicone in the face. Familiarity with this adverse reaction will help to prevent erroneous diagnoses such as idiopathic angioedema, Melkersson Rosenthal syndrome, and orofacial granulomatosis.
- Repeat treatment of acute hereditary angioedema attacks with open-label icatibant in the FAST-1 trial. [JOURNAL ARTICLE]
- Clin Exp Immunol 2014 Apr 22.
Hereditary angioedema (HAE) is characterized by potentially life-threatening recurrent episodes of edema. The open-label extension (OLE) phase of the For Angioedema Subcutaneous Treatment (FAST)-1 trial (NCT00097695) evaluated the efficacy and safety of repeated icatibant exposure in adults with multiple HAE attacks. Following completion of the randomized, controlled phase, patients could receive open-label icatibant (30 mg subcutaneously) for subsequent attacks. The primary endpoint was time to onset of primary symptom relief, as assessed by visual analogue scale (VAS). Descriptive statistics were reported for cutaneous/abdominal attacks 1-10 treated in the OLE phase and individual laryngeal attacks. Post-hoc analyses were conducted in patients with ≥5 attacks across the controlled and OLE phases. Safety was evaluated throughout. During the OLE phase, 72 patients received icatibant for 340 attacks. For cutaneous/abdominal attacks 1-10, the median time to onset of primary symptom relief was 1·0-2·0 h. For laryngeal attacks 1-12, patient-assessed median time to initial symptom improvement was 0·3-1·2 h. Post-hoc analyses showed the time to onset of symptom relief based on composite VAS was consistent across repeated treatments with icatibant. One injection of icatibant was sufficient to treat 88·2% of attacks; rescue medication was required in 5·3% of attacks. No icatibant-related serious adverse events were reported. Icatibant provided consistent efficacy and was well tolerated for repeated treatment of HAE attacks.
- [Neuraxial anesthesia for appendectomy in a patient with hereditary angioedema.] [LETTER]
- Rev Esp Anestesiol Reanim 2014 Apr 14.
- Treatment of hereditary angioedema: a review. [JOURNAL ARTICLE]
- Transfusion 2014 Apr 16.
Hereditary angioedema (HAE) is a rare autosomal dominant disorder characterized by recurrent attacks of self-limiting tissue swelling. The management of HAE has transformed dramatically with recently approved therapies in the United States. However, there is lack of awareness among physicians about these new modalities. The aim of this review is to update the practicing physician about various therapeutic options available for HAE patients. An exhaustive literature search of PubMed and OVID was performed to develop this article. Management of HAE is traditionally classified into treatment of acute attacks or on-demand therapy, short-term (preprocedural) prophylaxis, and long-term prophylaxis. Newer therapies include C1 esterase inhibitor (C1-INH) and contact system modulators, namely, ecallantide and icatibant. Recombinant C1-INH, which is available in Europe, is awaiting approval in the United States. C1-INH concentrate is approved for prophylaxis as well as on-demand therapy while ecallantide and icatibant are approved for acute treatment only. Effective HAE management further includes patient education, reliable access to specific medications, and regular follow-up to monitor therapeutic response and safety.
- Angioedema due to the new oral anticoagulant rivaroxaban. [Letter]
- Ann Card Anaesth 2014 Apr-Jun; 17(2):173-4.
- A Consensus Parameter for the Evaluation and Management of Angioedema in the Emergency Department. [JOURNAL ARTICLE]
- Acad Emerg Med 2014 Apr; 21(4):469-484.
Despite its relatively common occurrence and life-threatening potential, the management of angioedema in the emergency department (ED) is lacking in terms of a structured approach. It is paramount to distinguish the different etiologies of angioedema from one another and more specifically differentiate histaminergic-mediated angioedema from bradykinin-mediated angioedema, especially in lieu of the more novel treatments that have recently become available for bradykinin-mediated angioedema. With this background in mind, this consensus parameter for the evaluation and management of angioedema attempts to provide a working framework for emergency physicians (EPs) in approaching the patient with angioedema in terms of diagnosis and management in the ED. This consensus parameter was developed from a collaborative effort among a group of EPs and leading allergists with expertise in angioedema. After rigorous debate, review of the literature, and expert opinion, the following consensus guideline document was created. The document has been endorsed by the American College of Allergy, Asthma & Immunology (ACAAI) and the Society for Academic Emergency Medicine (SAEM).
- Recurrent angioedema: diagnosis strategy and biological aspects. [JOURNAL ARTICLE]
- Eur J Dermatol 2014 Apr 11.
The aetiologies of recurrent angioedema (AE) comprise the frequent histaminergic AE and the rare bradykinin-mediated AE. Diagnosis must be done carefully because they do not have the same treatment. Diagnosis strategy is clinical. The most specific symptoms for bradykinin AE are: isolated AE without wheals, long duration of the attack, abdominal localisation. The unique useful biological tests for the diagnosis of bradykinin AE are C1Inh exploration which is altered in hereditary AE (HAE) types I and II. No other biological test is useful in clinical practice at present. In case of suspicion of bradykinin AE with normal C1Inh, physicians must think of drug-induced AE. Hereditary AE with normal C1Inh may be associated with a mutation on gene F12 in 20% of cases. For 80% of patients without mutation, the diagnosis must be done very carefully.