Acquired angioedema (AAE) is a rare disorder that causes recurrent episodes of swelling (edema) of the face or body, lasting several days. People with AAE may have swelling of the face, lips, tongue, limbs, or genitals.
Angioedema
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Summary
Angioodema
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Angioodema
L'œdème de Quincke est un symptôme courant chez les patients présentant des bourrelets, soit lors de réactions anaphylactiques, soit chez les patients souffrant d'urticaire chronique. La coexistence à la fois des papules et de l'œdème de Quincke a été reconnue très tôt, principalement chez les patients présentant des réactions d'hypersensibilité aux aliments. En 1586, Marcello Donati a décrit le gonflement des lèvres chez un jeune patient de sexe masculin en réponse à l'ingestion d'œufs. Des rapports ultérieurs datant du milieu des années 1600 décrivaient des cas similaires d'angioede-ma en réponse au miel ou aux moules Jusqu'à la fin du XIXe siècle, l'œdème de Quincke était considéré exclusivement comme un signe d'urticaire et y était associé, même si certains cas d'œdème de Quincke isolés, c'est-à-dire sans poils, étaient rapportés dès le milieu du XIXe siècle. Diez ou Graves, par exemple, ont souligné le risque d'œdème laryngé et ont émis l'hypothèse que des gonflements similaires pourraient toucher la muqueuse du tractus gastro-intestinal En 1882, c'est Eugen Dinkelacker et son professeur Heinrich Irenäus Quincke (1842-1922), interniste allemand et chirurgien à Kiel, qui décrivit pour la première fois HAE. La thèse de doctorat de Dinkelacker) a documenté 14 cas d’œdème de Quincke, dont certains avec et l’autre sans papules. Rétrospectivement, au moins 2 des patients décrits présentaient un AOH: un patient de 22 ans présentant des crises récurrentes chroniques au visage, au larynx et à l'œdème de Quincke abdominaux d'une durée allant jusqu'à 3 jours depuis la petite enfance, et son fils en bas âge. Les deux patients semblaient avoir l'habitude de développer des symptômes précurseurs, y compris un érythème marginal. Quincke et Dinkelacker ont utilisé le terme «œdème de Quincke aigu» pour décrire l’état qu’ils ont décrit, qui est rapidement devenu l’oedème de Quincke. À l’époque, l’on jugeait que l’urticaire était d’origine «angioneurotique», c’est-à-dire qu'elle était due à une perméabilité accrue des capillaires due à un spasme en réponse à des influences neurogènes. Il n’est donc pas surprenant que Quincke et Dinkelacker aient tous deux suggéré que les cas d’angioedème qu’ils avaient observés étaient également dus à une «angionévrose». En fait, le terme «œdème angioneu-rotique» avait déjà été utilisé par d’autres auteurs, par exemple par Bannister en 1880 dans sa description de gonflements soudains et inflammatoires . Quincke, également connu pour avoir pratiqué la ponction lombaire
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What Is Acquired Angioedema?
Acquired angioedema (AAE) is a rare disorder that causes recurrent episodes of swelling (edema) of the face or body, lasting several days. People with AAE may have swelling of the face, lips, tongue, limbs, or genitals. People with AAE can have edema of the lining of the digestive tract, which can cause abdominal pain and nausea, as well as edema of the upper airway, which can be life-threatening. Swelling episodes may have various triggers, such as mild trauma (such as dental work), viral illness, cold exposure, pregnancy, certain foods, or emotional stress. The frequency of episodes is unpredictable and can vary widely.
There are two forms of AAE. Type 1 is associated with various other diseases including lymphoproliferative disorders, and autoimmune diseases that may not become apparent until years after the angioedema begins. Type 2 is associated with an autoimmune abnormality in which a person has autoantibodies against a protein in the blood called C1-INH. In some cases, it is hard to distinguish between AAE types 1 and 2.
Treatment options depend on the severity of symptoms, the parts of the body affected, and the type of AAE a person has. Various medications may be used to relieve symptoms or prevent complications. When an underlying disease is present, episodes may stop if the underlying disease is treated, but some people continue to experience episodes despite treatment. During severe or life-threatening episodes, intensive support may be needed (such as IV fluids or intubation for a blocked airway).
Source: Genetic and Rare Diseases (GARD) Information Center
Additional Materials (1)
Acquired Angioedema (AAE)
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Acquired Angioedema (AAE)
Medicosis Perfectionalis/YouTube
Symptoms
Angioedema
Image by James Heilman, MD
Angioedema
Angioedema of the lips (Dr. Bowden)
Image by James Heilman, MD
What Are the Signs and Symptoms of Acquired Angioedema?
Edema may develop in the face, lips, tongue, hands, arms, legs, genitals, or buttocks. The face and limbs are most commonly affected. It may also develop in the abdominal organs (such as the stomach, intestines, or bladder), which can cause abdominal pain, nausea, and vomiting. The upper airway can also be affected, which can be life-threatening if the airway becomes blocked.
When AAE is associated with an underlying disease such as a lymphoproliferative disorder or autoimmune disease, other symptoms associated with the underlying disease may also be present.
Source: Genetic and Rare Diseases (GARD) Information Center
Additional Materials (2)
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Angioedema of the face
Angioedema of the face, most strikingly in the upper lip. This was an acquired angioedema due to CD20+B cell lymphoma.
Image by Boussetta N1*, Ghedira H2, Hamdi MS1, Ariba BY1, Metoui L1, Ghasallah I1, Zriba S2, Louzir B1, Msaddak F2, Ajili F1 and Othmani S11 - Department of Internal Medicine, Military Hospital of Tunis, Tunisia2 - Department of Hematology, Military Hospital of Tunis, Tunisia/Wikimedia
Hereditary Angioedema vs Acquired angioedema
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Angioedema of the face
Boussetta N1*, Ghedira H2, Hamdi MS1, Ariba BY1, Metoui L1, Ghasallah I1, Zriba S2, Louzir B1, Msaddak F2, Ajili F1 and Othmani S11 - Department of Internal Medicine, Military Hospital of Tunis, Tunisia2 - Department of Hematology, Military Hospital of Tunis, Tunisia/Wikimedia
7:10
Hereditary Angioedema vs Acquired angioedema
Medicosis Perfectionalis/YouTube
Prognosis
Prognosis Icon
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Prognosis Icon
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What Is the Long-Term Outlook for People with Acquired Angioedema?
The most severe complication of AAE is being deprived of oxygen (asphyxiation) due to significant edema of the upper airway, if this occurs. This can be life-threatening. People with AAE should understand what steps to take in order to get emergency treatment in the case of airway involvement. Because AAE is a rare disorder, few emergency department providers are familiar with its treatment. It may be helpful to remain equipped with a document that briefly explains the diagnosis and outlines the treatment for acute attacks.
Compared with the general population, people with AAE have a higher chance to develop B-cell lymphomas.
Source: Genetic and Rare Diseases (GARD) Information Center
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Acquired Angioedema
Acquired angioedema (AAE) is a rare disorder that causes recurrent episodes of swelling (edema) of the face or body, lasting several days. People with AAE may have swelling of the face, lips, tongue, limbs, or genitals.