Otani Iris M, Banerji Aleena
Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, UCSF Medical Center, 400 Parnassus Avenue, Box 0359, San Francisco, CA 94143, USA.
Department of Medicine, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Cox 201 Allergy Associates, Boston, MA 02114, USA.
Immunol Allergy Clin North Am. 2017 Aug;37(3):497-511. doi: 10.1016/j.iac.2017.03.002. Epub 2017 May 15.
Acquired angioedema due to C1-INH deficiency (C1-INH-AAE) can occur when there are acquired (not inherited) deficiencies of C1-INH. A quantitative or functional C1-INH deficiency with negative family history and low C1q is diagnostic of C1-INH-AAE. The most common conditions associated with C1-INH-AAE are autoimmunity and B-cell lymphoproliferative disorders. A diagnosis of C1-INH-AAE can precede a diagnosis of lymphoproliferative disease and confers an increased risk for developing non-Hodgkin lymphoma. Treatment focuses on symptom control with therapies that regulate bradykinin activity (C1-INH concentrate, icatibant, ecallantide, tranexamic acid, androgens) and treatment of any underlying conditions.
由于C1-INH缺乏所致的获得性血管性水肿(C1-INH-AAE)可在出现获得性(非遗传性)C1-INH缺乏时发生。有阴性家族史且C1q水平低的定量或功能性C1-INH缺乏可诊断为C1-INH-AAE。与C1-INH-AAE相关的最常见情况是自身免疫和B细胞淋巴增殖性疾病。C1-INH-AAE的诊断可能先于淋巴增殖性疾病的诊断,并增加患非霍奇金淋巴瘤的风险。治疗重点是通过调节缓激肽活性的疗法(C1-INH浓缩物、依卡替班、艾卡拉肽、氨甲环酸、雄激素)控制症状以及治疗任何潜在疾病。