Interní Med. 2012; 14(1): 34-37
Hereditary angioedema and anaphylactic reaction after sting from hornets
- Ústav imunologie a alergologie, FN Plzeň
In patients with a long history of angioedema without urticaria was diagnosed hereditary angioedema (HAE) and launched a long-term
prophylactic treatment with attenuated androgens danazol. The patient was at the time of diagnosis of HAE, unfortunately, also treated
with ACE inhibitors for hypertension. After initiation of the therapy with danazol, and simultaneously change in therapy of hypertension
with discontinuation of ACE inhibitors, the status of the patient improved markedly in recent years and symptoms of HAE appeared sporadically
only during infection or following surgery. Since 2001 the patient after wasp or bee sting had a large edema and patient thought
that these are attacks of HAE. However at the turn of the millennium the patient had an anaphylactic reaction after a Hymenoptera insect
sting and in allergy testing were confirmed sensitization to Hymenoptera venom and we started the treatment with allergen immunotherapy.
Conclusion: Patients with HAE have discontinued treatment with ACE inhibitors because ACE inhibitors trigger angioedema.
Patients with HAE sometimes poorly differentiated between HAE attack and allergy attack with similar clinical manifestations. The possibility
of coincidence of two such serious diagnoses must be considered.
Keywords: edema, abdominal pain, C1 inhibitor, hereditary angioedema
Published: January 30, 2012 Show citation
