- Poster presentation
- Open Access
Laryngeal angioedema: do we need a new treatment algorithm in the ER?
© BioMed Central Ltd. 2010
- Published: 1 March 2010
- Allergic Reaction
- Airway Obstruction
Laryngeal angioedema (AE) could be life-threatening and is frequently due to allergic reactions. Other causes, that is bradykinin-mediated conditions, have to be taken into account. The aim of our survey is to provide information on the incidence, diagnosis and potentially new treatment options for laryngeal AE.
The data for 102 patients who were treated for swelling of the larynx at the Department of Otorhinolaryngology of Ludwig-Maximilians-University of Munich from 2004 to 2008 were evaluated in a retrospective survey.
Causes of laryngeal AE were in 26 patients an allergic reaction, in 33 cases were due to radiotherapy after cancer, 32 patients took an angiotensin-converting enzyme inhibitor (ACEI), one patient had a hereditary angioedema (HAE) and in 10 patients are unknown. All patients independent from the underlying cause were treated with high-dose intravenous steroids, 69 patients with antihistamines, 33 with epinephrine (inhalation or i.m.), two patients with ACEI-induced AE were successfully treated with icatibant. Ten patients needed an intubation, 11 a tracheotomy, one patient an emergency coniotomy to preserve the airway. All 11 tracheotomy patients suffered from cancer. Nine out of 10 intubated patients took an ACEI and were extubated on the ICU after 2 to 7 days.