Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.11.007
Brazilian Journal of Anesthesiology
Case Report

Anesthetic management of a patient with acquired angioedema submitted to broncofibroscopy: a case report

Melanie Barata, Ana Marques, Catarina Tiago, Marta Dias-Vaz, Nuno Losa, Carmen Oliveira

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Abstract

Acquired angioedema with C1 inhibitor deficiency (AAE-C1INH) is a very rare condition of bradykinin-mediated angioedema. One of its major complications is potentially life-threatening, laryngeal edema. We report a 53-year-old woman with AAE-C1INH proposed for an elective broncofibroscopy. The direct stimulation caused by broncofibroscopy poses a high risk of angioedema, thus presenting an anesthetic challenge. Due to the risk of death, it is essential to adopt preventive measures. Short-term prophylaxis was performed, and the acute treatment was readily available. A well-structured multidisciplinary periprocedural plan makes it possible to safely approach the airway, in a remote area of the hospital.

Keywords

Angioedema;  C1 Esterase Inhibitor;  Airway Management;  Bronchoscopy

References

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2 LS MacBeth, GW Volcheck, J Sprung, et al. Perioperative course in patients with hereditary or acquired angioedema J Clin Anesth, 34 (2016), pp. 385-391

3 C Hoyer, MR Hill, ER. Kaminski Angio-oedema: an overview of differential diagnosis and clinical management Continuing Education in Anaesthesia Critical Care & Pain, 12 (2012), pp. 307-311

4 M Maurer, M Magerl, I Ansotegui, et al. The international WAO/EAACI guideline for the management of hereditary angioedema – the 2017 revision and update Allergy, 73 (2018), pp. 1575-1596

5 T Bowen, M Cicardi, H Farkas, et al. 2010 International consensus algorithm for the diagnosis, therapy and management of hereditary angioedema Allergy Asthma Clin Immunol, 6 (2010), p. 24

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Braz J Anesthesiol

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