Nedelea Irena, Deleanu Diana
Allergology and Immunology Discipline, 'Iuliu Hațieganu' University of Medicine and Pharmacy, Cluj-Napoca 400012, Romania.
Department of Allergy, 'Professor Doctor Octavian Fodor' Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca 400162, Romania.
Exp Ther Med. 2019 Feb;17(2):1068-1072. doi: 10.3892/etm.2018.6982. Epub 2018 Nov 16.
Angioedema can occur in isolation, accompanied by urticaria, or as a feature of anaphylaxis in mast cell-mediated disorders, bradykinin-mediated disorders, as well as in others with unknown mechanisms, such as infections, rare disorders, or idiopathic angioedema. In mast cell-mediated angioedema, other signs and symptoms of mast cell-mediator release are frequently seen. However, clear evidence of mast cell degranulation may be absent in histaminergic angioedema. Bradykinin-induced angioedema is not associated with urticaria or other symptoms of type I hypersensitivity reactions. For many of the known triggers of angioedema, the mechanism is unclear. While mast cell and bradykinin-mediated angioedema are relatively well defined in terms of diagnostic and therapeutic approach, angioedema with unknown mechanisms represents a challenge for patients and clinicians alike. Elucidating the clinical pattern and the possible causes of isolated angioedema is the key to a correct diagnosis. This review summarizes the causes, and clinical features of angioedema, with a focus on isolated angioedema.
血管性水肿可单独出现,伴有荨麻疹,或作为肥大细胞介导性疾病、缓激肽介导性疾病以及其他机制不明的疾病(如感染、罕见疾病或特发性血管性水肿)中过敏反应的一个特征出现。在肥大细胞介导的血管性水肿中,经常可见肥大细胞介质释放的其他体征和症状。然而,在组胺能性血管性水肿中,可能不存在肥大细胞脱颗粒的明确证据。缓激肽诱导的血管性水肿与荨麻疹或I型超敏反应的其他症状无关。对于许多已知的血管性水肿触发因素,其机制尚不清楚。虽然肥大细胞和缓激肽介导的血管性水肿在诊断和治疗方法方面相对明确,但机制不明的血管性水肿对患者和临床医生来说都是一个挑战。阐明孤立性血管性水肿的临床模式和可能原因是正确诊断的关键。本综述总结了血管性水肿的病因和临床特征,重点是孤立性血管性水肿。