Lacuesta Gina, Betschel Stephen D, Tsai Ellie, Kim Harold
Halifax Allergy and Asthma Associates, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
Division of Allergy and Immunology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Allergy Asthma Clin Immunol. 2024 Dec 9;20(Suppl 3):65. doi: 10.1186/s13223-024-00934-3.
Angioedema can occur in the absence of urticaria and can be broadly divided into three main categories: mast cell-mediated (e.g., histamine), non-mast-cell-mediated (bradykinin-induced) and idiopathic angioedema. Non-mast-cell-mediated angioedema is largely driven by bradykinin. Bradykinin-induced angioedema can be hereditary, acquired or drug-induced, such as with angiotensin-converting enzyme (ACE) inhibitors. Although bradykinin-mediated angioedema can be self-limited, it can cause significant morbidity and laryngeal involvement may lead to fatal asphyxiation. The mainstays of management for angioedema are: (1) to avoid specific triggers (if possible and where known) and (2) treatment with medication (if indicated). For hereditary angioedema (HAE), there are specifically licensed treatments that can be used for the management of attacks, or for prophylaxis in order to prevent attacks. In this article, the authors will review the causes, diagnosis and management of angioedema.
血管性水肿可在无荨麻疹的情况下发生,大致可分为三大类:肥大细胞介导的(如组胺)、非肥大细胞介导的(缓激肽诱导的)和特发性血管性水肿。非肥大细胞介导的血管性水肿主要由缓激肽驱动。缓激肽诱导的血管性水肿可分为遗传性、获得性或药物性,如血管紧张素转换酶(ACE)抑制剂所致。虽然缓激肽介导的血管性水肿可能会自行缓解,但它可导致严重的发病率,喉部受累可能导致致命性窒息。血管性水肿的主要治疗方法是:(1)避免特定触发因素(如果可能且已知),(2)药物治疗(如果有指征)。对于遗传性血管性水肿(HAE),有专门获批的治疗方法可用于发作期的管理或预防发作。在本文中,作者将综述血管性水肿的病因、诊断和治疗。