Idiopathic non-histaminergic angio-oedema after routine extubation successfully treated with fresh frozen plasma.
Non-allergic angio-oedema is a potentially life-threatening condition typically seen in patients with hereditary or acquired angio-oedema caused by C1 inhibitor deficiency or an adverse drug reaction to angiotensin converting enzyme inhibitors. We report a case of sudden angio-oedema in a patient who developed severe swelling of the tongue and neck after routine extubation requiring resuscitative re-intubation. The oedema was refractory to conventional allergy treatment. Shortly thereafter, the patient was treated with fresh frozen plasma, and within a few hours his condition improved, allowing extubation. Familial history and exposure to potentially angio-oedema causative drugs were not evident. The serum complement status was normal, and no IgE sensitisation was detected. We therefore concluded that the patient was suffering from idiopathic non-histaminergic angio-oedema. To our knowledge, this is the first reported case of an acute, life-threatening attack of idiopathic non-histaminergic angio-oedema that was successfully treated with fresh frozen plasma.
Franzen
D
D
Department of Internal Medicine, Hospital of Zollikerberg, Zollikerberg, Zurich, Switzerland.
Ursprung
T
T
Wuthrich
B
B
Reber
A
A
D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy*; D000799:Angioedema / Q000209:etiology / Q000628:therapy*; D020878:Device Removal / Q000009:adverse effects; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011183:Postoperative Complications / Q000628:therapy*