Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete · 2019
[Classification and pathophysiology of angioedema].
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Buttgereit T, Maurer M
Аннотация
BACKGROUND: The classification of angioedema in daily clinical practice is often challenging.
OBJECTIVES: The goal is to review the most recent classification of angioedema and to discuss the underlying pathology.
MATERIALS AND METHODS: Current guidelines and research on the pathophysiology and classification of angioedema were evaluated.
RESULTS: Angioedema is mast cell mediator-induced or bradykinin-mediated. Classic examples for mast cell mediator-induced angioedema are acute angioedema due to allergic reactions or acute urticaria as well as recurrent angioedema in chronic urticaria. Bradykinin-mediated angioedema forms include hereditary angioedema and angiotensin converting enzyme (ACE) inhibitor-induced angioedema. Bradykinin-mediated angioedema is less common than mast cell mediator-induced angioedema and often more severe. The diagnostic workup of angioedema patients includes a good medical history and subsequent laboratory testing.
CONCLUSIONS: In most cases, mast cell mediator-induced and bradykinin-mediated forms of angioedema are readily classified clinically and/or by laboratory tests. In very rare cases, however, the cause and mediators of angioedema remain unknown.
OBJECTIVES: The goal is to review the most recent classification of angioedema and to discuss the underlying pathology.
MATERIALS AND METHODS: Current guidelines and research on the pathophysiology and classification of angioedema were evaluated.
RESULTS: Angioedema is mast cell mediator-induced or bradykinin-mediated. Classic examples for mast cell mediator-induced angioedema are acute angioedema due to allergic reactions or acute urticaria as well as recurrent angioedema in chronic urticaria. Bradykinin-mediated angioedema forms include hereditary angioedema and angiotensin converting enzyme (ACE) inhibitor-induced angioedema. Bradykinin-mediated angioedema is less common than mast cell mediator-induced angioedema and often more severe. The diagnostic workup of angioedema patients includes a good medical history and subsequent laboratory testing.
CONCLUSIONS: In most cases, mast cell mediator-induced and bradykinin-mediated forms of angioedema are readily classified clinically and/or by laboratory tests. In very rare cases, however, the cause and mediators of angioedema remain unknown.