Evaluation of the patients who apply to the emergency departmentwi̇th angioedema

Aims: Angioedema (AO) is a disorder which is usually seen in the subcutaneous tissue characterized by edema, which is temporarily localized in the submucosal layer in the respiratory and gastrointestinal system. Angioedema occurs most often in the extremities, the face, the genital organs, the airways and the gastrointestinal tract, although it is seen anywhere in the body. The diagnosis of angioedema is made by a quick preliminary evaluation, detailed history and physical examination. The patient should be intervened at the earliest time to reduce morbidity and possible mortality in an acute attack. The aim of this study is to investigate the demographic data, symptoms, signs, episodes, trigger factors, laboratory and radiological findings of the patientsapplied to the emergency service because of angioedema, treatments applied to the patients and their responds to the treatments Material-Method: Between 15.04.2016 and 30.11.2016, Erciyes University Medical Faculty Hospital Emergency Service included in the study patients who applied with a clinical chart of angioedema above 18 years of age. The demographic ( age, gender, occupation, emergency service admission time) and clinical characteristics (first episode history, number of episodes, resume, family history, complaints, time to start complaints, angioedema, physical examination findings, positive laboratory results, consultation status, treatment, hospitalization or discharge status) of these patients were evaluated with a prepared form. The obtained data were transferred to the SPSS V20 program. Data analysis descriptive statistics, comparison of two independent groups the Mann-Whitney U, for the comparison of multiple independent groups Kruskal-Wallis and for the comparison of categorical data the Chi-square test were used. p <0.05 was considered significant. Results: A total of 100 angioedema patients were included in the study, 46 of whom were women. The mean age of the patients was calculated as 41.48 ± 14.097 years. The proportion of AO patients to all Emergency Departments was 0.70% . 49% of the patients were working. It was found that the patients mostly (63%) applied to the emergency services during the seasonal transition periods (April-May and September). 45% of the patients experienced the first attack and the mean number of attacks was 4.06 ± 7.53. It was found that the number of attacks was higher in patients with urticaria, patients with atopy and urticaria in their history, and those with respiratory system (p <0.05). 93% of the patients were complaining of swelling and 54% of the patients complained of itching and redness. Edema was most commonly seen in the periorbital region and on the lips. Atopy (31%), urticaria (22%) and hypertension (12%) were the most common in the patients' resume. Drug use (52%) was the most frequent cause of AO. The most common of these was found to be nonsteroid antiinflammatory drugs (23%). The cause of the complaint in 34% of the patients was unknown. There were no abnormal laboratory findings except eosinophilia (12%). All patients received antihistamine and steroid therapy. Adrenalin was administered in 67% of patients, TDP and C1 INH in 3% of patients. 89% of patients has been consulted with dermatology department. 73 patients were hospitalized. No mortal condition encountered. Conclusion: Although angioedema is rarely encountered with emergency care, patients' clinics may worsen rapidly and become fatal. Simultaneous evaluation and treatment of patients will be life-saving. Deeping the information about the anamnesis, self and family history of AO patients, especially emergency care physicians, can help to classify the disease and thus determine the most appropriate treatment approach. In addition, the use of drugs that cause angioedema attacks, detection of factors such as anxiety and measures taken in the transitional seasons, can be of great benefit in protecting the patients from the attacks.