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如何避免被模仿血管性水肿的病症误导:假性血管性水肿综述

How Not to Be Misled by Disorders Mimicking Angioedema: A Review of Pseudoangioedema.

作者信息

Andersen Michelle Fog, Longhurst Hilary J, Rasmussen Eva Rye, Bygum Anette

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Sjaelland, Koege, Denmark.

出版信息

Int Arch Allergy Immunol. 2016;169(3):163-70. doi: 10.1159/000445835. Epub 2016 Apr 22.

Abstract

BACKGROUND

Angioedema is a vascular reaction involving the lower dermis, subcutis and/or submucosal tissue and causing a temporary localized swelling in any part of the body. For many health care professionals, the diagnosis presents an ongoing challenge; several disorders may manifest with subcutaneous or submucosal swelling and falsely be assumed to be angioedema. The clinicians at the emergency department and in the immunology/allergy clinics must be skilled at recognizing the features of angioedema and its differential diagnosis.

METHODS

The review is based on a literature search with specific indexing terms in PubMed, a review of bibliographies and the authors' clinical experience.

RESULTS

The most essential diseases that mimic angioedema, the so-called pseudoangioedemas, will each be discussed and illustrated by clinical photos, pointing out key features that help clarify the diagnoses and differentiate these from classic angioedema.

CONCLUSIONS

A variety of dermatologic conditions can cause swelling that resembles angioedema, some with a potentially fatal outcome if misdiagnosed. Knowledge of pseudoangioedema is fundamental in the emergency setting when handling patients with edema and should be kept in mind when assessing an atypical angioedema case.

摘要

背景

血管性水肿是一种累及真皮深层、皮下组织和/或黏膜下组织的血管反应,可导致身体任何部位出现暂时性局部肿胀。对于许多医疗保健专业人员而言,该疾病的诊断一直是一项挑战;多种病症可能表现为皮下或黏膜下肿胀,因而被错误地认定为血管性水肿。急诊科以及免疫/过敏科诊所的临床医生必须熟练掌握血管性水肿的特征及其鉴别诊断方法。

方法

本综述基于在PubMed中使用特定索引词进行的文献检索、参考文献回顾以及作者的临床经验。

结果

将对每种模仿血管性水肿的最主要疾病,即所谓的假性血管性水肿进行讨论,并配以临床照片加以说明,指出有助于明确诊断并将其与典型血管性水肿相鉴别的关键特征。

结论

多种皮肤病状况可导致类似血管性水肿的肿胀,其中一些若误诊可能会产生致命后果。在急诊环境中处理水肿患者时,了解假性血管性水肿至关重要,在评估非典型血管性水肿病例时应牢记这一点。

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