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Heterogeneous predisposing factors and etiology in uvula edema patients

Barbarroja-Escudero J1, Asúnsolo-Del-Barco A2, Sánchez-González MJ1, Rodríguez-Rodríguez M1, Alvarez-Mon M1

1Servicio de Enfermedades del Sistema Inmune-Alergia, Hospital Universitario Príncipe de Asturias, Departamento de Medicina y Especialidades Médicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares (Madrid), Spain.
2Department of Surgery, Medical and Social Sciences, University of Alcala, Alcalá de Henares (Madrid), Spain.

J Investig Allergol Clin Immunol 2019; Vol. 29(4)
doi: 10.18176/jiaci.0324

Background: Edema of the uvula (EU) may appear in isolation or in association with other associated clinical manifestations such as urticaria, angioedema or anaphylaxis. EU may lead to upper airway obstruction, provoking obstructive respiratory distress and asphyxia.
Objective: We sought to investigate the etiology of, and predisposing factors for, EU in a large population of patients referred to an outpatient clinic.
Methods: In this 3-year-follow-up cohort study, 171 patients presenting with EU were identified and classified as having isolated EU or non-isolated EU. The etiology of each patient's condition was studied and possible predisposing factors recorded. An allergy work-up and a statistical study (bivariate/multivariate analyses) were performed.
Results: The predisposing factors for both groups of EU patients were found to be different. The etiology of the problem was identified for the majority of the patients; allergy to Anisakis simplex was the most common cause for both groups. Non-steroidal anti-inflammatory drugs and antibiotics were also found as etiologies for both groups.
Conclusions: Isolated EU was found to be associated with snoring, an elongated uvula and having suffered from previous episodes of EU. Associations among groups of EU patients and gender, obesity, smoking, alcohol consumption, personal and family atopy or obstructive sleep apnea, were not demonstrated. Allergy to A. simplex was the most commonly recorded cause.

Key words: Allergy, Anisakis simplex, Elongated uvula, Obesity, Smoking, Snoring, Uvula edema