Abstract
Laryngeal swelling can be life threatening with etiologies including angioedema and cellulitis. While both involve swelling of subcutaneous tissues angioedema involves extravasation of fluid into interstitium while cellulitis is caused by direct extension of a spreading infection. The cause of angioedema involves multiple etiologies with response to treatment varying with underlying pathophysiology. While some exposures are extrinsic, and thus able to be avoided, estrogen or estrogenic excess has been shown to be intimately involved in certain patients presenting with acute angioedema. We present a gravid patient with new onset neck swelling and airway compromise requiring airway protection and emergent cesarean section delivery. The patient provides insight into the multiple risk factors and difficulties in discerning a single inciting event while emphasizing the importance of obstetric physician awareness to angioedema, etiologies, and management.
Highlights
Angioedema can affect any organ and cause life threatening airway compromise
Though a relationship between attacks and increased estrogen has been observed in individuals with traditional hereditary subtypes, it is recognized that there are estrogen dependent etiologies that present without the typical pattern of complement consumption
Angioedema has been described with many etiologies, which all result in increased capillary permeability with fluid extravasation into subcutaneous or submucosal tissue manifesting as localized non pitting swelling
Summary
Angioedema can affect any organ and cause life threatening airway compromise. The multiple etiologies provide a diagnostic challenge especially in an acute patient. Angioedema, Pregnancy, Airway, Gravid, Estrogen, Hereditary, Idiopathic, Cellulitis This case presents such a patient with multiple risk factors including pregnancy itself.
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