Drug-Related Angioedema
Description General and Supportive Measures Medicine Treatment Referral ICD-10 code: T78.3 DESCRIPTION Local swelling of skin and/or mucosal tissue. May occur in isolation or together with urticaria or anaphylaxis. It must be distinguished from recurrent non-pruritic angioedema which has a hereditary component and does not respond to the treatment below. Complement C4 and C1 esterase inhibi
General and Supportive Measures
ICD-10 code: T78.3
DESCRIPTION
Local swelling of skin and/or mucosal tissue. May occur in isolation or together with urticaria or anaphylaxis. It must be distinguished from recurrent non-pruritic angioedema which has a hereditary component and does not respond to the treatment below. Complement C4 and C1 esterase inhibitor levels are used to help to distinguish the two entities.
GENERAL AND SUPPORTIVE MEASURES
- Stop potentially causative drug(s).
- Monitor the airway closely and intubate early if necessary.
MEDICINE TREATMENT
If symptoms and signs of anaphylaxis: treat as for anaphylaxis, see Anaphylaxis/ anaphylactic reactions.
If angioedema in isolation:
- Chlorphenamine, oral, 0.1 mg/kg/dose 6 hourly.
AND
- Prednisone, oral, 1 - 2 mg/kg daily for 1 week.
OR
If unable to take orally and ≥ 2 years:
- Promethazine, IM, 0.5 mg/kg immediately, followed by above oral therapy.
REFERRAL
- All cases after stabilisation for confirmation of diagnosis and long-term management.
- Recurrent non-pruritic angioedema.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 25: Drug Allergies, 24.2 Immediate Hypersensitivity Reactions, 24.2.3 Drug-Related Angioedema