title: Life Threatening Idiopathic Recurrent Angioedema Responding to Cannabis.
abstract: We present a case of a 27-year-old man with recurrent episodes of angioedema since he was 19, who responded well to treatment with medical grade cannabis. Initially, he responded to steroids and antihistamines, but several attempts to withdraw treatment resulted in recurrence. In the last few months before prescribing cannabis, the frequency and severity of the attacks worsened and included several presyncope events, associated with scrotal and neck swelling. No predisposing factors were identified, and extensive workup was negative. The patient reported that he was periodically using cannabis socially and that during these periods he was free of attacks. Recent data suggest that cannabis derivatives are involved in the control of mast cell activation. Consequently, we decided to try a course of inhaled cannabis as modulators of immune cell functions. The use of inhaled cannabis resulted in a complete response, and he has been free of symptoms for 2 years. An attempt to withhold the inhaled cannabis led to a recurrent attack within a week, and resuming cannabis maintained the remission, suggesting a cause and effect relationship.
authors.affiliation: General Intensive Care Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beersheba, Israel.
authors.forename: Amit
authors.initials: A
authors.lastname: Frenkel
authors.affiliation: General Intensive Care Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beersheba, Israel.
authors.forename: Aviel
authors.initials: A
authors.lastname: Roy-Shapira
authors.affiliation: General Intensive Care Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beersheba, Israel.
authors.forename: Brotfain
authors.initials: B
authors.lastname: Evgeni
authors.affiliation: General Intensive Care Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beersheba, Israel.
authors.forename: Koyfman
authors.initials: K
authors.lastname: Leonid
authors.affiliation: Infection Control and Hospital Epidemiology Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beersheba, Israel.
authors.forename: Abraham
authors.initials: A
authors.lastname: Borer
authors.affiliation: General Intensive Care Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beersheba, Israel.
authors.forename: Moti
authors.initials: M
authors.lastname: Klein