Division of Immunology and Allergy, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Division of Immunology/Allergy Section, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio; Bernstein Allergy Group,Bernstein Clinical Research Center, Cincinnati, Ohio.
Ann Allergy Asthma Immunol. 2022 Dec;129(6):692-702. doi: 10.1016/j.anai.2022.08.003. Epub 2022 Aug 19.
To review the various types of angioedema including diagnosis and treatment.
PubMed search of articles in the English language of various types of angioedema.
Articles on the subject matter were selected and reviewed.
Herein, a case-based approach is presented for discussing the major types of angioedema, including the following: hereditary angioedema types I and II and normal complement, acquired angioedema, angiotensin-converting enzyme-induced angioedema, and histaminergic and nonhistaminergic angioedema. Emerging treatments of hereditary angioedema including targets of prekallikrein, DNA vector technology replacing C1-INH protein, and CRIPSR technology targeting prekallikrein among many others are explored. In addition, other causes and mimickers of angioedema are briefly reviewed. Finally, a novel algorithm is proposed to help guide the treating physician through the workup and management of patients with suspected idiopathic angioedema unresponsive to conventional therapy with antihistamines.
Over the years, many strides have been made in both understanding the pathophysiology of various types of angioedema and expansion of treatment options. It is important for clinicians to be aware of current and emerging treatment options. We provide a novel practical algorithm to guide clinicians in challenging cases of idiopathic angioedema refractory to antihistamines.
综述各种类型的血管性水肿，包括诊断和治疗。
在英文文献中搜索有关各种类型血管性水肿的文章，并在 PubMed 上进行检索。
选择并回顾了有关该主题的文章。
本文通过病例为基础的方法讨论了主要类型的血管性水肿，包括遗传性血管性水肿 I 型和 II 型及正常补体、获得性血管性水肿、血管紧张素转换酶诱导的血管性水肿、以及组胺能和非组胺能血管性水肿。探讨了遗传性血管性水肿的新兴治疗方法，包括激肽原前肽的靶点、用 C1-INH 蛋白替代 DNA 载体技术，以及针对激肽原的 CRISPR 技术等。此外，还简要回顾了血管性水肿的其他病因和类似物。最后，提出了一种新的算法，以帮助指导治疗医师对疑似特发性血管性水肿患者进行检查和管理，这些患者对抗组胺药物常规治疗无反应。
多年来，人们在理解各种类型血管性水肿的病理生理学以及扩大治疗选择方面都取得了很大进展。临床医生了解当前和新兴的治疗选择非常重要。我们提供了一种新的实用算法，以指导临床医生治疗对抗组胺药物无反应的特发性血管性水肿的疑难病例。
