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Hereditary angioedema — SCE Acute Medicine MCQ

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HardAllergy and ImmunologyHereditary angioedemaSCE Acute Medicine

A patient with hereditary angioedema develops progressive tongue swelling without urticaria, wheeze or hypotension. She has not improved after antihistamine. What is the most appropriate syndrome-specific treatment while the airway is assessed?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Give C1-esterase inhibitor with airway assessment

The best answer is “Give C1-esterase inhibitor with airway assessment”. This is correct because hereditary angioedema is bradykinin mediated and does not reliably respond to antihistamines, corticosteroids or adrenaline. Airway planning remains paramount. Anaphylaxis treatment is appropriate when mast-cell features are present, but repeatedly substituting it for specific therapy here delays control of a potentially fatal upper-airway attack.

Reference: NICE TA606 hereditary-angioedema recommendations: https://www.nice.org.uk/guidance/ta606/chapter/1-Recommendations