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Allergic angioedema: case report A 51-year-old woman developed allergic angioedema during treatment with calcium sulfate. The woman was treated with plaster fixation containing calcium sulfate for the fracture of the lateral malleolus of the right lower limb one month prior to the onset of the disease. After 3 days, she developed pruritus at the fixed position, and she used a metal sweater needle to itch. After 7 days, she developed eyelid oedema, fever and vomiting. Thus, the woman took loratadine for desensitisation. Subsequently, her eyelid oedema slightly subsided. However, she developed fever after 15 days (highest body temperature: 38.7°℃). Subsequently, she was treated for upper respiratory tract infection at a community hospital. She had intermittent fever along with weakness, generalised rash and oedema. She took unspecified antipyretic drugs and aztreonam to treat herself at home. However, no recovery was observed. On 02 November 2018, she was admitted due to intermittent fever for more than half a month along with generalised swelling. Physical examination showed body temperature of 37.8°C, heart rate of 98 beats/min, diffuse flushing in the skin throughout the body, swelling (non-pitting oedema), eyelid congestion and oedema, clear breath sounds in both lungs. Subsequently, her plaster bandage was removed. There was no obvious pitting oedema in the anterior tibia of both lower extremities. A significant reddish purple and rash on the right lower extremity in the area covered by the plaster bandage was observed. The edges of the reddish purple parallel to the edges of the plaster coverage. The reddish purple areas did not fade when pressed with some flaky desquamation. An ECG showed sinus tachycardia. Laboratory examinations was notable for allergic angioedema, myocardial injury and hypoproteinemia. After admission, she was asked to remove the plaster bandage and replace it with external fixation device (resin). She received methylprednisolone. The dose of methylprednisolone was gradually reduced. Eventually, the oedema and rash subsided. She also received albumin and creatine phosphate sodium. Then, her myocardial metabolism was improved. After 10 days of treatment, she was cured and discharged. After discharge from the hospital, she took oral niuhuangqingwei pills containing calcium sulfate [gypsum] to treat herself due to dysphoria. Then, she presented with chest rashes along with pruritus and facial oedema symptoms again. Therefore, she was treated with loratadine and methylprednisolone. Eventually, the symptoms disappeared and the treatment was stopped. Later, it was confirmed that her allergic angioedema was associated with calcium sulfate. Qiu LL, et al. A case of angioedema caused by medical gypsum Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 38: 388, No. 5, 20 May 2020. Available from: URL: 803517831 http://doi.org/10.3760/cma.j.cn121094-20190919-00386 [Chinese; summarised from a translation]

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