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      Snoring-Induced Vibratory Angioedema

      research-article
      The American Journal of Case Reports
      International Scientific Literature, Inc.
      Angioedema, Sleep Apnea, Obstructive, Snoring, Urticaria

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          Abstract

          Patient: Female, 70

          Final Diagnosis: Snoring induced vibratory angioedema

          Symptoms: Swelling of tongue • roof of mouth and throat • multiple episodes at night

          Medication: —

          Clinical Procedure: Continuous positive airway pressure therapy

          Specialty: Allergology

          Objective:

          Rare disease

          Background:

          Vibratory angioedema (VA) is a rare physical urticaria, with symptoms of itching and swelling of the skin or mucosa when it is exposed to vibration. Avoidance of vibration is the best way to manage this condition. This case report will assist physicians to diagnose this rare condition. Here, a previously unpublished potential successful treatment modality is being presented, with good symptom control, along with some photographs taken during an acute attack. A literature review points towards potential undiagnosed cases.

          Case Report:

          A 70-year-old woman had multiple emergency department visits for tongue and throat swelling over 3 years. The episodes always happened at night. Detailed history elicited some episodes of itching and swelling of hands when driving as well as significant snoring while sleeping. Physical examination was unremarkable except for morbid obesity. Complement factor 4 and C1esterase inhibitor level were within normal limits. A tentative diagnosis of angioedema induced by oropharyngeal vibration from snoring was made. A sleep study confirmed sleep apnea with severe snoring. After CPAP (continuous positive airway pressure) treatment, she had successful symptom control.

          Conclusions:

          Snoring-induced VA is very likely an under-diagnosed condition in the community. The typical history is the key to the diagnosis. This condition could be confirmed by vibration test or by the resolution of symptoms with elimination of vibration. Effective symptom control is possible by avoidance of oropharyngeal vibration from snoring with the administration of CPAP therapy, making it a potential novel indication for this condition.

          Related collections

          Most cited references9

          • Record: found
          • Abstract: found
          • Article: not found

          The definition and diagnostic testing of physical and cholinergic urticarias--EAACI/GA2LEN/EDF/UNEV consensus panel recommendations.

          The recommendations for the definition and diagnosis presented in this position paper are the result of a panel consensus meeting held in December 2008 in Berlin. This consensus meeting was a joint initiative of EAACI (European Academy of Allergology and Clinical Immunology) Dermatology Section, the EU-funded network of excellence, GA(2)LEN (Global Allergy and Asthma European Network), the EDF (European Dermatology Forum) and UNEV (urticaria network e.V.). The aim of these recommendations is to improve the diagnosis and management of patients with physical urticaria or cholinergic urticaria and to promote research and a better understanding of these diseases. Our recommendations used the paper produced by a 1996 expert meeting (1) and they acknowledge the latest changes in our understanding of physical urticarias and cholinergic urticaria as well as the recent development of novel diagnostic tools. In addition, this consensus paper highlights areas of need for further research.
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            • Record: found
            • Abstract: found
            • Article: not found

            Physical urticaria.

            J Dice (2004)
            Physical urticarias are a unique subgroup of chronic urticaria in which patients develop urticaria secondary to environmental stimuli. Common triggers include exercise, temperature changes, cold, heat, pressure, sunlight, vibration, and water. Systemic symptoms have occurred during severe episodes. Physical urticarias are responsible for approximately 20% to 30% of all cases of chronic urticaria. A basic knowledge of these unusual disorders is important for all healthcare providers. This article covers the following types of physical urticarias: dermatographism, cholinergic urticaria, local heat urticaria, exercise-induced anaphylaxis, vibratory angioedema, solar urticaria, and aquagenic urticaria.
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              • Record: found
              • Abstract: not found
              • Article: not found

              Vibratory angioedema: a hereditary type of physical hypersensitivity.

                Bookmark

                Author and article information

                Journal
                Am J Case Rep
                Am J Case Rep
                amjcaserep
                The American Journal of Case Reports
                International Scientific Literature, Inc.
                1941-5923
                2015
                01 October 2015
                : 16
                : 700-702
                Affiliations
                Department of Internal Medicine, MidMichigan Medical Center, University of Michigan Health System, Midland, MI, U.S.A.
                Author notes

                Authors’ Contribution:

                [A]

                Study Design

                [B]

                Data Collection

                [C]

                Statistical Analysis

                [D]

                Data Interpretation

                [E]

                Manuscript Preparation

                [F]

                Literature Search

                [G]

                Funds Collection

                Conflict of interest: None declared

                Corresponding Author: Ipe Kalathoor, e-mail: dripegk@ 123456yahoo.com
                Article
                894636
                10.12659/AJCR.894636
                4597856
                26437464
                bbddddc2-495c-42dc-81e1-49ad40fc9ea8
                © Am J Case Rep, 2015

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License

                History
                : 12 May 2015
                : 20 June 2015
                Categories
                Articles

                angioedema,sleep apnea, obstructive,snoring,urticaria
                angioedema, sleep apnea, obstructive, snoring, urticaria

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