Clinical and laboratory characteristics of paediatric patients diagnosed with angioedema: a retrospective evaluation

Angioedema is a heterogeneous clinical condition characterized by transient swelling of the deeper dermal and submucosal tissues and may occur either in isolation or in association with urticaria. Despite its clinical importance, data regarding clinical phenotypes, triggering factors, and inflammatory laboratory markers in paediatric angioedema remain limited.

This study aimed to retrospectively evaluate the clinical characteristics and laboratory parameters of paediatric patients with angioedema.

In this single-centre retrospective study, medical records of paediatric patients aged 0-18 years diagnosed with angioedema between January 2024 and January 2025 were reviewed. Demographic characteristics, angioedema phenotype (isolated angioedema vs. angioedema with urticaria), triggering factors, drug-triggered angioedema, and atopic comorbidities were analysed. Laboratory parameters included hemogram indices, C-reactive protein (CRP), total immunoglobulin E (IgE), complement levels (C3 and C4), and neutrophil-to-lymphocyte ratio (NLR). Appropriate parametric and non-parametric statistical tests were applied.

A total of 103 paediatric patients were included. Angioedema accompanied by urticaria was more frequent in females, whereas isolated angioedema predominated in males (p = 0.004). Upper airway involvement, multiple site involvement, and atopic comorbidities were significantly more common in patients with urticaria-associated angioedema (p < 0.05). Idiopathic angioedema showed higher neutrophil counts (p = 0.033), while CRP (p = 0.018) and total IgE levels (p = 0.026) were elevated in trigger-associated angioedema. Drug-triggered angioedema occurred less frequently in patients with atopic comorbidities (p < 0.001) and was associated with higher NLR values (p < 0.001) and lower basophil counts (p = 0.038).

Paediatric angioedema shows distinct clinical phenotypes and laboratory patterns depending on urticaria and triggering factors. Inflammatory markers such as neutrophil counts, CRP, NLR, and basophil levels may help characterize the inflammatory profile of angioedema. Larger multicentre studies are needed to confirm these findings.