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Consensus Report Aims to Prevent Misdiagnosis and Under-Treatment of Angioedema

Leading allergy organizations shed light on overlooked disorder (Nov. 9)

When the symptoms of an uncommon illness mimic a number of other conditions, it can be difficult for medical professionals to properly diagnose and treat patients. That's why four leading allergy/immunology organizations have released a consensus report to help set a new standard for the commonly misdiagnosed, under-recognized, and under-treated condition known as angioedema — the rapid swelling of deep layers of skin and tissue.

The report was released on November 9 during the Annual Scientific Meeting of the American College of Allergy, Asthma, and Immunology (ACAAI) in Anaheim, California. It is the latest consensus report from the International Collaboration in Asthma, Allergy, and Immunology (iCAALL) — a joint project of the ACAAI; the American Academy of Allergy, Asthma , and Immunology (AAAAI); the European Academy of Allergy and Clinical Immunology (EAACI); and the World Allergy Organization (WAO).

Angioedema is similar to urticaria (hives) since the two conditions have similar mechanisms. However, swelling caused by angioedema is below the surface of the skin, sometimes in addition to above-surface welts. Some forms of angioedema are hereditary. A more common form of the disorder may occur in a subgroup of patients taking angiotensin-converting enzyme (ACE) inhibitors — a class of medications commonly prescribed for patients with high blood pressure or heart conditions.

Symptoms experienced by patients with angioedema may include swollen eyes and mouth, swelling of the hands and feet, difficulty breathing, stomach cramping, and swelling of the lining of the eyes. For patients with hereditary or acquired angioedema, symptoms may occur after trauma in association with infections, with allergic reactions, or with other illnesses.

“Considering the potential for misdiagnosis of angioedema and the varied allergic and nonallergic causes, using the report's recommendations of best clinical practices for diagnosing and managing all its forms will help allergist/immunologists and other healthcare providers ensure optimal care for their patients,” said A. Wesley Burks, MD, president of the AAAAI.

The full report will be published in the December issue of the Annals of Allergy, Asthma, and Immunology.

Source: ACAAI; November 9, 2012.

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