Related Experiment Video
Updated: Aug 28, 2025
04:34
Surgical Treatment of an Endolymphatic Sac Tumor
Published on: May 26, 2023
797
Acquired vibratory angioedema with a severe impact on work performance
M E Gatica-Ortega1, I Sánchez-Matas2, L Sánchez-Muñoz3
1Dermatology Department, Hospital Universitario de Toledo, Avenida del Río Guadiana s/nº, cp: 45007 Toledo, Spain.
Occupational Medicine (Oxford, England)
|September 21, 2022
Summary
Vibratory angioedema, triggered by tools like pneumatic hammers, can severely impair work. This case highlights omalizumab as an effective treatment for this rare condition, even when associated with chronic spontaneous urticaria.
Area of Science:
- Immunology
- Dermatology
- Occupational Health
Background:
- Vibratory urticaria/angioedema is a rare inducible urticaria triggered by mechanical vibrations.
- It can significantly impact daily activities and work performance, particularly in occupational settings.
- Misdiagnosis is possible without specific vibratory provocation tests.
Observation:
- A construction worker presented with acquired vibratory angioedema linked to chronic spontaneous urticaria, triggered by a pneumatic hammer.
- The patient experienced severe work impairment due to the condition.
- Specific diagnostic tests were crucial to differentiate from delayed pressure urticaria.
Findings:
- Omalizumab treatment led to an immediate and complete resolution of symptoms.
- Analysis included Urticarial Activity Score, vibratory provocation vortex test, and immunological markers.
- This is the first reported case of vibratory angioedema triggered by a pneumatic hammer and the first to respond to omalizumab.
Implications:
- Vibratory angioedema should be considered in patients with inducible urticaria and occupational exposures.
- Omalizumab shows promise as a therapeutic option for severe cases of vibratory angioedema.
- Accurate diagnosis through specific provocation tests is essential for appropriate management.
Related Concept Videos
01:29Angina III: Clinical Manifestations and Assessment
19
Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
19
01:20Angina V: Nursing Management
35
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
35
01:25Aortic Regurgitation III: Medical Management
35
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
35
01:20Myasthenia Gravis: Overview and Treatment
1.8K
Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
1.8K
01:26Angina IV: Management
16
IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
16
01:27Assessment of the Cardiovascular System III: Palpation
456
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
456