A Case of Vibratory Angioedema (Vibratory Urticaria)

Abstract

　A 27-year-old male visited our clinic exhibiting edema of the left hand. His history indicated that he had developed swelling of both hands approximately 6-7 times per year for the last few years. The swelling usually improved within one day. A few days before his visit, he had assembled furniture and used a hammer with his left hand. His left hand then presented with marked edema and a mild itch. There was edema on the back of the left hand and on the left fingers during his visit to our clinic. Laboratory tests indicated normal levels of complement and C1 esterase inhibitor activity. A vibration load test was carried out by vibrating the extensor surface of his left forearm for 10 minutes using a shaking, Thermo-Mixer. Marked edema with redness and slight itch appeared along the left forearm beyond the contact point of the shaking mixer. The swelling with redness around the vibration site continued for 7 hours. The pressure load test was negative and dermatography was positive. The diagnosis was vibratory angioedema (vibratory urticaria) .