title: [Bradykinin-mediated angioedema secondary to angiotensin converting enzyme: initiate treatment from the prehospital phase].
abstract: We are reporting the case of a bradykinin-mediated angioedema, secondary to the angiotensin converting enzyme inhibitors, which delayed treatment could have unfavorably influence the vital prognostic of the patient. Initially, the patient had an isolated edema of the superior lip. Prehospital treatment included methylprednisolone, hydroxyzine and epinephrine. The patient was subsequently taken to the emergency department. His situation deteriorated. An edema of the cheeks and the tongue appeared. The transfer of the patient to an emergency department, specializing in kinin angioedema was organized, in order for the patient to receive specific treatments. After a subcutaneous injection of icatibant, the situation improved very rapidly, with a regression of the edema. This observation is consistent with the early use of the specific therapeutic in bradykinin-mediated angioedema. Any delay in administering the treatment can negatively impact the prognostic. The availability of such treatments should therefore be organized during the prehospital phase.
authors: Samu-Smur 93, hôpital Avicenne, Assistance publique-Hôpitaux de Paris, université Paris-13, 125, rue de Stalingrad, 93000 Bobigny, France. nicolas.javaud@jvr.aphp.fr
authors: N
authors: N
authors: Javaud
authors: O
authors: O
authors: Fain
authors: B
authors: B
authors: Bernot
authors: F
authors: F
authors: Adnet
authors: F
authors: F
authors: Lapostolle
mesh_terms: D000799:Angioedema / Q000209:etiology / Q000628:therapy*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001920:Bradykinin / Q000009:adverse effects / Q000031:analogs & derivatives / Q000502:physiology*; D004632:Emergency Medical Services; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D006919:Hydroxyzine / Q000627:therapeutic use; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008046:Lip / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000893:Anti-Inflammatory Agents; D006634:Histamine H1 Antagonists; D006919:Hydroxyzine; C065679:icatibant; D001920:Bradykinin; D008775:Methylprednisolone