Life Threatening Idiopathic Recurrent Angioedema Responding to Cannabis

摘要

We present a case of a 27-year-old man with recurrent episodes of angioedema since he was 19, who responded well to treatment with medical grade cannabis. Initially, he responded to steroids and antihistamines, but several attempts to withdraw treatment resulted in recurrence. In the last few months before prescribing cannabis, the frequency and severity of the attacks worsened and included several presyncope events, associated with scrotal and neck swelling. No predisposing factors were identified, and extensive workup was negative. The patient reported that he was periodically using cannabis socially and that during these periods he was free of attacks. Recent data suggest that cannabis derivatives are involved in the controlof mast cell activation. Consequently, wedecided to try a course of inhaled cannabis asmodulators of immune cell functions. The use ofinhaled cannabis resulted in a completeresponse, and he has been free of symptoms for 2years. An attempt to withhold the inhaledcannabis led to a recurrent attack within aweek, and resuming cannabis maintained theremission, suggesting a cause and effectrelationship.