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特发性血管性水肿的鉴别诊断、管理问题及其解决方法

Differential Diagnosis and Management Issues of Idiopathic Angiooedema and their Resolution.

作者信息

Zanichelli Andrea, Mansi Marta, Wu Maddalena A, Azin Giulia, Cicardi Marco

机构信息

Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan and Ospedale L. Sacco Milan, Milan, Italy.

出版信息

J Crit Care Med (Targu Mures). 2015 Jun 5;1(2):55-60. doi: 10.1515/jccm-2015-0008. eCollection 2015 Apr.

Abstract

Angiooedema is a local and self-limiting swelling of the subcutaneous and sub mucosal tissues, produced by vasoactive peptides that temporary increase the vascular permeability. It is recognized that recurrent angiooedema exposes patients to the risk of fatalities and reduced quality of life, being in some circumstances associated with a critical condition. Angiooedema can occur with or without wheals. The first symptom is urticaria, the second is a distinct nosologic entity. In absence of an identifiable cause, recurrent angiooedema without wheals can be defined as idiopathic and marked"idiopathic histaminergic angiooedema" when it is responsive to anti histamine treatment, and "idiopathic non-histaminergic angiooedema" when it is not. Furthermore, idiopathic non-histaminergic angiooedema can be diagnosed as hereditary or sporadic by family history. In this review, we summarize the approaches to diagnose and treat different forms of idiopathic angiooedema.

摘要

血管性水肿是皮下和黏膜下组织的局部性、自限性肿胀,由血管活性肽引起,这些肽会暂时增加血管通透性。人们认识到,复发性血管性水肿会使患者面临死亡风险并降低生活质量,在某些情况下与危急状况相关。血管性水肿可伴有或不伴有风团出现。第一种症状是荨麻疹,第二种是一种独特的疾病实体。在没有可识别病因的情况下,无风团的复发性血管性水肿可定义为特发性,当对抗组胺治疗有反应时称为“特发性组胺能性血管性水肿”,无反应时称为“特发性非组胺能性血管性水肿”。此外,特发性非组胺能性血管性水肿可根据家族史诊断为遗传性或散发性。在本综述中,我们总结了诊断和治疗不同形式特发性血管性水肿的方法。

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