Onset of angioedema following a viper bite: different options for diagnostic procedure in an emergency department

The unexpected onset of an angioedema in a patient observed in the emergency department after a viper bite, gave the opportunity to consider some different etiopathogenetic hypothesis and to discuss the most correct diagnostic procedure. The patient was a 60-year-old man who was treated with sartans for hypertension and reported a recent diagnosis of monoclonal gammopathy of uncertain significance. Based on the patient history and on the clinical aspects of the angioedema, the authors consider the possibility of an acquired non-allergic angioedema and its probable close relationship with a lymphoproliferative disorder.