Duvancić Tomislav, Lugović-Mihić Liborija, Brekalo Ante, Situm Mirna, Sinković Ana
University Department of Dermatovenereology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Acta Clin Croat. 2011 Dec;50(4):531-8.
Angioedema indicates acute subcutaneous edema that characterizes improperly restricted cutaneous or mucous membrane swelling, which can occur only once or be relapsing. Edema usually occurs in the periorbital area, lips, tongue, extremities and intestinal wall. It has turned out that angioedema is usually caused by the use of angiotensin-converting enzyme inhibitors (ACE) or allergies to certain allergens (allergic or IgE-mediated angioedema), followed by C1 inhibitor deficiency (hereditary and acquired angioedema), or the cause is unknown (idiopathic angioedema). It has been shown that patients with angioedema often have urticaria, which is noted in approximately 50% of cases. Usually there is a type I allergic reaction to some food allergens or drugs or insect stings. The most common causes of allergic angioedema are bee and wasp stings, reactions to medications or injections for sensitivity testing, and certain foods (especially eggs, shellfish and nuts). In diagnostic terms, it is important to determine the potential allergen, which is commonly performed with cutaneous tests, such as prick test, etc. The main risk of angioedema is swelling of the tongue, larynx and trachea, which can lead to airway obstruction and death, therefore tracheotomy is indicated in such cases. The initial treatment of patients with most forms of angioedema included administration of antihistamines and glucocorticoids, while epinephrine is given if there is fear from laryngeal edema.
血管性水肿是指急性皮下水肿，其特征为皮肤或黏膜肿胀受限不当，可仅发生一次或反复发作。水肿通常发生在眶周区域、嘴唇、舌头、四肢和肠壁。已证实血管性水肿通常由使用血管紧张素转换酶抑制剂（ACE）或对某些过敏原过敏（过敏性或IgE介导的血管性水肿）引起，其次是C1抑制剂缺乏（遗传性和获得性血管性水肿），或病因不明（特发性血管性水肿）。已表明血管性水肿患者常伴有荨麻疹，约50%的病例有此症状。通常对某些食物过敏原、药物或昆虫叮咬存在I型过敏反应。过敏性血管性水肿最常见的病因是蜜蜂和黄蜂叮咬、对药物或敏感性测试注射的反应以及某些食物（尤其是鸡蛋、贝类和坚果）。在诊断方面，确定潜在过敏原很重要，这通常通过皮肤试验进行，如点刺试验等。血管性水肿的主要风险是舌头、喉部和气管肿胀，可导致气道阻塞和死亡，因此在这种情况下需进行气管切开术。大多数类型血管性水肿患者的初始治疗包括给予抗组胺药和糖皮质激素，若担心发生喉水肿则给予肾上腺素。
