Angioedema is the rapid swelling of the area beneath the skin, often presenting rapidly as a red and bumpy area referred to as “hives”. It has numerous causes and in some cases can be life threatening due to airway obstruction when swelling is excessive. This is the case presentation of a single 27 year old male.
This single individual had been having recurrent attacks of angioedema since he was 19. The severity and frequency of attacks had increased over the years, and the last few months had progressed to at least twice per month. 2 of the recent episodes had been considered life threatening due to imminent airway obstruction. Due to the severity of the condition the patient had been advised to carry an EpiPen at all times.
For medical treatment the patient was placed on several preparations of anti-histamines but the attacks persisted and supplemental steroids were necessary.
This Israeli patient informed his doctors that when he used marijuana (cannabis) recreationally, he seemed to have no attacks. There are studies showing that marijuana can modulate the immune response and can thus have an important role in the regulation of inflammation.
His doctors prescribed 20 grams of marijuana per month to be inhaled 2-3 times weekly. The patient used this medicine for 2 years and did not have a single attack and had no side effects. After 2 years he attempted to stop the medicine on his own, but developed a recurrent severe attack 1 week later.
Upon resuming his marijuana medicine he had no more attacks for the following 4 month observation period. This pattern meets the scientific criteria for causality, meaning it is valid to presume the marijuana is solely responsible for the beneficial effect.
The authors do not know the exact mechanism of action but the patient used medical grade marijuana which affects both CB1 and CB2 receptors. The results are promising for the future use of medicinal marijuana.
