Type I anaphylactic reaction due to contrast induced angioedema causing neck swelling: the role of sitting fiberoptic bronchoscopy in emergent intubation

authors:

avatar Ali Dabbagh ORCID 1 , * , avatar Habibollah Saadat 2 , avatar Mahnoosh Foroughi 2 , avatar Samira Rajaei ORCID 3 , avatar Reza Khajenouri 4 , avatar Farhad Solatpour 4 , avatar Abbas Arjmand Shabestari 5 , avatar Taraneh Faghihi Langroudi 5 , avatar Hamid Ghaderi 2

Professor of Cardiac Anesthesia; Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Cardiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Immunology Department, Tehran University of Medical Sciences, Tehran, Iran
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Radiology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Journal of Cellular & Molecular Anesthesia: Vol.1, issue 3; e149514
article type: Brief Communications
DOI: https://doi.org/10.22037/jcma.v1i3.12006

how to cite: Dabbagh A, Saadat H, Foroughi M, Rajaei S, Khajenouri R, et al. Type I anaphylactic reaction due to contrast induced angioedema causing neck swelling: the role of sitting fiberoptic bronchoscopy in emergent intubation. J Cell Mol Anesth. 2016;1(3):e149514. https://doi.org/10.22037/jcma.v1i3.12006.

Abstract

Contrast induced angioedema is a rapidly progressive state involving a number of organ systems including the upper airway tract; which is usually a type I anaphylactic reaction also known as immediate hypersensitivity reaction. Prompt preservation of the respiratory tract is the cornerstone of this situation. The use of fiberoptic bronchoscope for tracheal intubation though very helpful, has some special considerations due to the anatomic distortions created by edema.This manuscript describes a patient with contrast induced angioedema managed successfully. Serum levels of IgE were highly increased during the first hours after the event; while serum levels of complement were normal. However, rapid airway management and prophylactic intubation saved the patient and prevented the possible aftermath of airway obstruction.Keywords: airway management; type I anaphylactic reaction, angioedema; fiberoptic bronchoscope.Conflict of interest: none of the authors has any conflict of interest.