Dobson G, Edgar D, Trinder J
The Ulster Hospital, Belfast, Northern Ireland.
Anaesth Intensive Care. 2003 Feb;31(1):99-102. doi: 10.1177/0310057X0303100120.
We describe the management of an 83-year-old woman who presented with upper airway obstruction due to angioedema of the tongue. Following definitive airway management, investigation showed a diagnosis of acquired C1 esterase inhibitor deficiency (acquired angioedema) that was considered to be subsequent to haematological malignancy. Resolution of the macroglossia followed treatment with C1 esterase inhibitor concentrate, but the patient failed to wean from ventilatory support and died in the Intensive Care Unit. This case report highlights the potential for acquired angioedema to cause upper airway obstruction. The various treatment modalities for acquired C1 esterase inhibitor deficiency are summarized.
我们描述了一位83岁女性的治疗情况,该患者因舌血管性水肿导致上呼吸道梗阻。在进行了确定性气道管理后,检查显示诊断为获得性C1酯酶抑制剂缺乏症(获得性血管性水肿),被认为继发于血液系统恶性肿瘤。使用C1酯酶抑制剂浓缩物治疗后巨舌症得到缓解,但患者未能脱离通气支持,最终在重症监护病房死亡。本病例报告强调了获得性血管性水肿导致上呼吸道梗阻的可能性。文中总结了获得性C1酯酶抑制剂缺乏症的各种治疗方式。