Abstract
Objectives: Very few studies on angioedema have concentrated on pediatric cases. Even fewer have studied the differences between pediatric and adult angioedema. From limited published literature, the two entities tend to have different etiologies and management strategies. We reviewed our experience with adult and pediatric angioedema.
Methods: A retrospective chart review was performed for all adult and pediatric patients in a large county hospital covering 15 years. Eighty-seven independent data points were collected on each patient, and statistical analysis was performed.
Results: 102 total cases of angioedema were identified; 28 were pediatric cases. The etiology of pediatric angioedema was most commonly idiopathic (68%), followed by insect bites (18%) and food allergy (7%). The most common presenting symptoms of pediatric angioedema were peripheral soft tissue swelling (96%), itching (21%), and urticaria (14%); pediatric patients were significantly more likely to have urticaria than adults (14% vs 2.5%; P = 0.02) and less likely to have shortness of breath (3.6% vs 22%, P = 0.029) or dysphagia (0% vs 15%, P = 0.029). The airway was affected in pediatric patients only 14% of the time, versus 59% in adults (P < 0.001); only one child required intubation.
Conclusion: Pediatric angioedema is a different entity than adult angioedema, more typically causing peripheral swelling and urticaria and less frequently involving the airway. Over a 15-year period, only one case of pediatric angioedema required intubation.