Skip to main content

Advertisement

Log in

Non-episodic angioedema associated with eosinophilia following Mycoplasma pneumoniae infection

  • Case Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Episodic angioedema with eosinophilia is characterized by recurrent angioedema, peripheral eosinophilia, fever, weight gain, elevated serum immunoglobulin M (IgM), and a benign course lacking any internal organ involvement. A non-episodic variant has also been reported which is limited to a single attack and normally is less severe than the episodic type. We report a case of Mycoplasma pneumoniae infection with dermatological manifestation that was followed by non-episodic angioedema with eosinophilia including fever, weight gain, and elevated serum IgM. Even though the patient’s clinical characteristics resemble episodic angioedema with eosinophilia as reported by Gleich, angioedema was non-episodic. This may be due to systemic corticosteroid treatment which was prescribed because of persistent skin manifestation following M. pneumoniae infection. The current report is the first observation suggesting that angioedema associated with eosinophilia may be triggered by atypical bacterial infection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Gleich GJ, Schroeter AL, Marcoux P, Sachs MI, O’Connel EJ, Kohler PF (1984) Episodic angioedema associated with eosinophilia. N Engl J Med 310:1621–1626

    PubMed  CAS  Google Scholar 

  2. Putterman C, Barak V, Caraco Y, Neuman T, Shalit M (1993) Episodic angioedema with eosinophilia: a case associated with T cell activation and cytokine production. Ann Allergy 70:243–248

    PubMed  CAS  Google Scholar 

  3. Kawano M, Muramoto H, Tsunoda S, Koni I, Mabuchi H, Yachie A, Miyawaki T (1996) Absence of CD69 expression on peripheral eosinophils in episodic angioedema and eosinophilia. Am J Hematol 53:43–45

    Article  PubMed  CAS  Google Scholar 

  4. Nakashima K, Sakurada T, Imayama S, Masukawa S, Ember JA, Hugli TE, Abe M (1998) A case of episodic angioedema associated with blood eosinophilia: upregulated C5a receptor expression on eosinophils. Allergy 53:320–323

    Article  PubMed  CAS  Google Scholar 

  5. Morgan SJ, Prince HM, Westerman DA, McCormack C, Glaspole I (2003) Clonal T-helper lymphocytes and elevated IL-5 levels in episodic angioedema and eosinophilia (Gleich’s syndrome). Leuk Lymphoma 44:1623–1625

    Article  PubMed  Google Scholar 

  6. Okubo Y, Sato E, Hossain M, Ota T, Yoshikawa S, Sekiguchi M (1995) Periodic angioedema with eosinophilia: increased serum level of interleukin 5. Intern Med 34:108–111

    Article  PubMed  CAS  Google Scholar 

  7. Tillie-Leblond I, Gosset P, Janin A, Salez F, Prin L, Tonnel AB (1998) Increased interleukin-6 production during the acute phase of the syndrome of episodic angioedema and hypereosinophilia. Clin Exp Allergy 28:491–496

    Article  PubMed  CAS  Google Scholar 

  8. Lassalle P, Gosset P, Gruart V, Prin L, Capron M, Lagrue G, Kusnierz JP, Tonnel AB, Capron A (1990) Presence of antibodies against endothelial cells in the sera of patients with episodic angioedema and hypereosinophilia. Clin Exp Immunol 82:38–43

    PubMed  CAS  Google Scholar 

  9. Matsuda M, Fushimi T, Nakamura A, Ikeda S (2006) Nonepisodic angioedema with eosinophilia: a report of two cases and a review of the literature. Clin Rheumatol 25:422–425

    Article  PubMed  Google Scholar 

  10. Waites KB, Talkington DF (2004) Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev 17:697–728

    Article  PubMed  CAS  Google Scholar 

  11. Winter LK, Spiegel JH, King T (2007) Dermatopathic lymphadenitis of the head and neck. J Cutan Pathol 34:195–197

    Article  PubMed  Google Scholar 

  12. Sutherland ER, Martin RJ (2007) Asthma and atypical bacterial infection. Chest 132:1962–1966

    Article  PubMed  CAS  Google Scholar 

  13. Ruuth E, Praz F (1989) Interactions between mycoplasmas and the immune system. Immunol Rev 112:133–160

    Article  PubMed  CAS  Google Scholar 

  14. Shikiji T, Urano Y, Takiwaki H, Arase S (1997) A case of episodic angioedema associated with eosinophilia. J Med Invest 44:103–108

    PubMed  CAS  Google Scholar 

  15. Oktenli C, Bulucu F, Gurbuz M, Bozoglu E, Oguz Y, Koc B (2001) Observations on edema formation and resolution in Gleich syndrome: essential role of the kidneys in effective arterial blood volume regulation. Am J Nephrol 21:154–161

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors wish to thank Rajam Csordas for critical reading.

Disclosure

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christian J. Wiedermann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Stockner, I., Thaler, J., Fichtel, G. et al. Non-episodic angioedema associated with eosinophilia following Mycoplasma pneumoniae infection. Clin Rheumatol 27, 1573–1576 (2008). https://doi.org/10.1007/s10067-008-0990-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-008-0990-1

Keywords

Navigation