Idiopathic non-histaminergic angio-oedema after routine extubation successfully treated with fresh frozen plasma

Anaesthesia. 2006 Jul;61(7):698-701. doi: 10.1111/j.1365-2044.2006.04648.x.

Abstract

Non-allergic angio-oedema is a potentially life-threatening condition typically seen in patients with hereditary or acquired angio-oedema caused by C1 inhibitor deficiency or an adverse drug reaction to angiotensin converting enzyme inhibitors. We report a case of sudden angio-oedema in a patient who developed severe swelling of the tongue and neck after routine extubation requiring resuscitative re-intubation. The oedema was refractory to conventional allergy treatment. Shortly thereafter, the patient was treated with fresh frozen plasma, and within a few hours his condition improved, allowing extubation. Familial history and exposure to potentially angio-oedema causative drugs were not evident. The serum complement status was normal, and no IgE sensitisation was detected. We therefore concluded that the patient was suffering from idiopathic non-histaminergic angio-oedema. To our knowledge, this is the first reported case of an acute, life-threatening attack of idiopathic non-histaminergic angio-oedema that was successfully treated with fresh frozen plasma.

Publication types

  • Case Reports

MeSH terms

  • Airway Obstruction / etiology
  • Airway Obstruction / therapy*
  • Angioedema / etiology
  • Angioedema / therapy*
  • Device Removal / adverse effects
  • Humans
  • Intubation, Intratracheal
  • Male
  • Middle Aged
  • Plasma*
  • Postoperative Complications / therapy*