A man takes peanut and develop stridor, neck swelling, tongue swelling and hoarseness of voice. Most probable diagnosis is –
Correct Answer: Angioneurotic edema
Description: Angioedema is an area of swelling of the lower layer of skin and tissue just under the skin or mucous membranesThe swelling may occur in the face, tongue, larynx, abdomen, or arms and legs.Often it is associated with hives, which are swelling within the upper skin.Onset is typically over minutes to hours The underlying mechanism typically involves histamine or bradykinin. The version related to histamine is due to an allergic reaction to agents such as insect bites, foods, or medications. The version related to bradykinin may occur due to an inherited problem known as C1 esterase inhibitor deficiency, medications known as angiotensin-conveing enzyme inhibitors, or a lymphoproliferative disorder. Effos to protect the airway may include intubation or cricothyroidotomy. Histamine-related angioedema can be treated with antihistamines, coicosteroids, and epinephrine.In those with bradykinin-related disease a C1 esterase inhibitor, ecallantide, or icatibant may be used.Fresh frozen plasma may be used insteadIn the United States the disease affects about 100,000 people a year. Ref Davidson 23rd edition pg 451
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