Van Sickels Nicholas J, Hunsaker Robert B, Van Sickels Joseph E
Internal Medicine, Tulane Medical Center, New Orleans, Louisiana, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Feb;109(2):168-72. doi: 10.1016/j.tripleo.2009.09.031.
Hereditary angioedema (HAE) is a nonhistamine-mediated process causing edema of the tissues of the upper airway, dermis, and subcutaneous tissue. As such it does not respond well to epinephrine, antihistamines, or glucocorticoids. Instead it is treated with attenuated androgenic hormones, episolone aminocaproic acid (EACA), or tranexamic acid, C1 esterase inhibitor, and fresh-frozen plasma. Medical or surgical management of the airway may be necessary in an acute situation. Minor trauma, such as that associated with dental procedures and psychologic stress, may precipitate an attack; however, swelling may not manifest itself for 12-48 hours after a procedure. Symptoms of angioedema may be exacerbated in these patients if they are given an angiotensin-converting enzyme inhibitor. This paper reviews this entity and presents 2 patients who presented for acute care with dental/oral surgical complaints.
遗传性血管性水肿（HAE）是一种非组胺介导的过程，可导致上呼吸道、真皮和皮下组织的水肿。因此，它对肾上腺素、抗组胺药或糖皮质激素反应不佳。相反，它采用减毒雄激素、ε-氨基己酸（EACA）或氨甲环酸、C1酯酶抑制剂和新鲜冷冻血浆进行治疗。在急性情况下，可能需要对气道进行药物或手术处理。轻微创伤，如与牙科手术和心理压力相关的创伤，可能会引发发作；然而，手术后肿胀可能在12 - 48小时后才会显现。如果这些患者服用血管紧张素转换酶抑制剂，血管性水肿的症状可能会加重。本文对该疾病进行了综述，并介绍了2例因牙科/口腔外科主诉前来接受急症治疗的患者。
