Urticaria Angioedem is the most common genetically linked clinical disorder caused by deficiency of a protein associated with complement activation. There is a currently widespread recognition in the allergy and clinical immunology community as a clinical entity. It is known to cause attacks that may be complicated by incapacitating cutaneous swelling, life-theatening upper airway obstruction, and severe gastrointestinal colic. Some authors find that occasionally normal values does not rule out HAE. C1-INH studies should be performed if there is a high index of clinical suspicion. The importance of making the correct diagnosis cannot be overemphasized. It can avert fatal consequences, such as airway obstruction, and unnecessary abdominal surgery. C1-INH replacement therapy represent an efficacious treatment of acute attacks. The application of preventive measures avoid need for dramatic emergency interventions.
C1-INH has been developed and clinical trials are ongoing. Hereditary angioedema is characterized by episodic local subcutaneous edema and mucosal swelling of the upper respiratory and gastrointestinal tracts, caused by a genetic insufficiency of C1 esterase inhibitor. It should be noted that this is a rare disorder and much of the literature is based on case studies or small series. Angioedema can be precipitated by trauma, swelling in extremities following typing, prolonged writing, hammering, and other physical activities. Women often have attacks during menses, but attacks are less frequent during pregnancy. Often, the frequency and intensity of attacks lessen after menopause. Use of birth control pills and hormone replacement therapy is associated with an increase in the frequency and severity of attacks.
Causes of Urticaria Angioedem
Common causes of Urticaria Angioedem
- Genetic insufficiency( C1 esterase inhibitor).
- Emotional stress.
- Coexisting illnesses
Symptoms of Urticaria Angioedem
Common Symptoms of Urticaria Angioedem
- Abdominal pain.
Treatment of Urticaria Angioedem
Common Treatment of Urticaria Angioedem
- Antifibrinolytic agents. Tranexamic acid is preferred to epsilonamicraproic acid, although is not as efficient as the androgen therapy. It is mostly used when prophylaxis is indicated before puberty. A starting dose of 1 1.5 g of tranexamic acid up to two to three times a day should be used depending on disease severity.
- Attenuated androgens might be more effective than antifibrinolitic agents. Contraindications include pregnancy and lactation, cancer and childhood.
- Patient possession of C1-INH concentrate. It is recommended to offer to patients C1-INH concentrate on demand for personal use at home or with travel, as 50 75% have a life-threatening attack at some time
- Treatment of HAE during pregnancy has special problems. Ideally, all prophylactic drugs should be stopped during pregnancy and, if possible, before concept