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Nonepisodic angioedema with eosinophilia following a rose-thorn prick injury

Authors :
Kimitoshi Matsuo
Hidenori Takahashi
Hiroki Nagamatsu
Ryutaro Hirose
Yuka Yamada
Hiroaki Takei
Naoya Toba
Mio Toyama-Kousaka
Shinichiro Ota
Miwa Morikawa
Masaharu Shinkai
Source :
International Journal of Cardiology. Cardiovascular Risk and Prevention, Vol 22, Iss , Pp 200301- (2024)
Publication Year :
2024
Publisher :
Elsevier, 2024.

Abstract

Background: Nonepisodic angioedema with eosinophilia (NEAE) is a condition marked by angioedema and significant eosinophilia and often linked with atopic dermatitis. It predominantly affects young Asian women and occurs more frequently in the autumn and winter. Despite over 100 reported cases, its etiology and pathogenesis remain unclear. Case presentation: A 23-year-old Japanese female florist presented with acute arm swelling following rose-thorn pricks to her hands and fingers in spring. One week later, she developed progressive symmetrical non-pitting edema in her lower legs and a 3 kg weight gain without any rash. She had a history of oral allergy syndrome to apples and pears for which allergen-specific IgE were previously detected. Blood tests showed significant eosinophilia (14,930 cells/μL) and elevated thymus and activation-regulated chemokine (TARC) levels (12,864 pg/mL). Thyroid disease, autoimmune disorders, and hematologic malignancies were ruled out. Normal cardiac markers and a whole-body computed tomography excluded visceral organ involvement. She was diagnosed with NEAE and treated with oral prednisolone, which resolved the edema within 10 days. Prednisolone was tapered gradually on an outpatient basis without recurrence. Conclusion: A review of the literature indicates that NEAE triggered by subcutaneous antigen exposure may not follow the typical age or seasonal patterns. Direct subcutaneous antigen exposure, including rose-thorn pricks, can trigger NEAE. Clinicians should consider NEAE in atypical presentations and thoroughly investigate preceding episodes.

Details

Language :
English
ISSN :
27724875
Volume :
22
Issue :
200301-
Database :
Directory of Open Access Journals
Journal :
International Journal of Cardiology. Cardiovascular Risk and Prevention
Publication Type :
Academic Journal
Accession number :
edsdoj.320c57f004854078b9f63417e39a382c
Document Type :
article
Full Text :
https://doi.org/10.1016/j.ijcrp.2024.200301