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Pediatric Angioedema Differential Diagnoses

  • Author: Shih-Wen Huang, MD; Chief Editor: Harumi Jyonouchi, MD  more...
 
Updated: Jul 28, 2016
 
 

Diagnostic Considerations

A variety of other diagnostic possibilities should also be considered in children with possible angioedema.

For other discussions on angioedema, see the overview topics Acquired Angioedema and Hereditary Angioedema.

Cellulitis

Usually, this is caused by gram-positive bacterial infection. Pain and fever are common.

Erysipelas

This is caused by group A beta streptococci. Tenderness, fever, and redness are common.

Lymphedema

Chronic thickening of tissues occurs in lymphedema. This contrasts with the acute stretching of tissue observed in angioedema.

Collagen vascular disorders

Patients with systemic lupus erythematosus (SLE) or other collagen vascular disorders should have a history of systemic illness, indicating the presence of vasculitis. Laboratory findings reflect features of chronic inflammatory conditions.

Acute contact dermatitis

In acute contact dermatitis, the patient has a history of contact with sensitizing agents. The rash is always accompanied by intense pruritus.

Idiopathic scrotal edema in children

The etiology of this disorder is unknown, but swelling is limited to the scrotal area. Rarely, it causes systemic symptoms.

Rosenthal-Melkersson syndrome

In this rare neurologic disorder, recurrent facial edema, recurrent peripheral facial nerve palsy, and remarkable fissuring of the tongue are characteristic. Onset is in childhood or early adolescence.

Laryngeal swelling due to anaphylaxis

Most patients have a history of intense allergic diathesis. The anaphylaxis may be caused by ingestion of food, drugs, insect sting, or latex allergy. Idiopathic anaphylaxis, which is rare in children, may occasionally cause difficulty in the differential diagnosis.

Surgical abdomen

Severe pain caused by hereditary angioedema can be difficult to distinguish from conditions leading to surgical abdomen. The latter include intestinal obstruction and appendicitis. In addition, Crohn disease may cause chronic pain and diarrhea. History and physical examination should be helpful to distinguish those conditions with the aid of imaging studies.

Angioedema with eosinophilia

A total of 11 patients were reported from Japan. They were reported selectively in young females. The common features are angioedema with eosinophilia (eosinophil count of 7,839 +/- 6,008). Serum C-reactive protein and immunoglobulin E levels remained normal. They improved within 8 weeks, even without corticosteroid therapy.[18]

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Shih-Wen Huang, MD Professor Emeritus of Pulmonology and Allergy, Department of Pediatrics, University of Florida College of Medicine

Shih-Wen Huang, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology

Disclosure: Nothing to disclose.

Chief Editor

Harumi Jyonouchi, MD Faculty, Division of Allergy/Immunology and Infectious Diseases, Department of Pediatrics, Saint Peter's University Hospital

Harumi Jyonouchi, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American Association of Immunologists, American Medical Association, Clinical Immunology Society, New York Academy of Sciences, Society for Experimental Biology and Medicine, Society for Pediatric Research, Society for Mucosal Immunology

Disclosure: Nothing to disclose.

Acknowledgements

C Lucy Park MD, Head, Division of Allergy, Immunology, and Pulmonology, Associate Professor, Department of Pediatrics, University of Illinois at Chicago College of Medicine

C Lucy Park is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Medical Association, Chicago Medical Society, Clinical Immunology Society, and Illinois State Medical Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

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The mechanism of angioedema resulting from C1-esterase inhibitor deficiency.
Angioedema secondary to ACE inhibitors
 
 
 
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