Angioedema of the lips!!
Angioedema is a result of the fast onset of an increase in local vascular permeability and leakage in subcutaneous or submucosal tissue. Histamine and bradykinin are the most recognized vasoactive mediators known to be critical in the pathologic process. It’s an autosomal dominant disorder that is typically caused by a deficiency in or dysfunction of C1 esterase inhibitor (in complement system). This leads to elevated bradykinin, which causes edema. Bradykinin mediated vasodilation results in rapid fluid accumulation in the interstitial space resulting in edema of the underlying tissue. Angioedema can also be mediated by mechanisms that interfere with bradykinin production or metabolism. ACE is one of the enzymes that degrades bradykinin and is blocked by ACE nhibitors, can result in angioedema as a medication side effect. A hereditary defeciency of C1-esterase inhibitor results in continuous activation of complement system resulting in excess production of bradykinin and kallikrein. Angioedema can also be due to an autoimmune disorder that results in antibody formation against C1 inhibitor. An episode of angioedema can be triggered in susceptible individuals as a result of consumption of foods that are vasodilators like alcohol and cinnamon, as well as after a dental procedure, stress, or trauma. It often involve the lip, eyes, and face. However, it may affect the respiratory and gastrointestinal mucosa. Laryngeal edema causing laryngospasm and airway obstruction is by far the most life-threatening complication. In rapid airway compromise, local anaphylaxis protocol (epinephrine) should be followed and mechanical intervention may be needed, either by intubation or cricothyrotomy/tracheotomy. The need for intubation is significantly greater with presentations of laryngeal or pharyngeal involvement versus swelling of the lips and face.
Hemodynamic stimuli&nonhemodynamic stimuliEffects of sugar on teeth
