Occupationally acquired vibratory angioedema with secondary carpal tunnel syndrome

After several years of occupational exposure to vibration, a man developed episodic vibratory hand swelling, erythema, and pruritus. He subsequently developed symptoms compatible with carpal tunnel syndrome, but his median nerve conduction velocity remained normal. After experimental vibration of the forearm, plasma histamine levels in the ipsilateral antecubital vein rose in association with localized angioedema and slowed median nerve conduction velocity. There was no evidence of other causes of angioedema. Occupational exposure to vibration may predispose to the development of vibratory angioedema, which may predispose to intermittent compression neuropathy.