Leone Fabrizio, Gori Alessandra, Cinicola Bianca Laura, Colletti Giorgio, Pignataro Elia, Capponi Martina, Brindisi Giulia, Anania Caterina, Zicari Anna Maria
Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, 00161, Italy.
Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, 00161, Italy.
Ital J Pediatr. 2025 Jan 5;51(1):2. doi: 10.1186/s13052-024-01833-4.
Angioedema is a condition marked by sudden, intense swelling of the subcutaneous and submucosal tissues, typically associated with hypersensitivity reactions, genetic mutations, or reactions to medications. It can also result from contact with allergens such as nickel, leading to dermatitis.
A 12-year-old girl presented at our Pediatric Immunology and Allergology service with recurrent labial angioedema for over a year, linked to the consumption of legumes and tomatoes, and following the use of a metal flute. Despite a nickel-positive patch test and subsequent avoidance of nickel, her symptoms persisted. Further investigations to rule out other causes of angioedema were unproductive. It was later discovered that she had been wearing a nickel-containing orthodontic device applied a year earlier. The removal of this orthodontic device led to a cessation of the angioedema episodes, highlighting nickel as the likely trigger.
This case underscores the importance of considering prolonged nickel exposure from dental devices as a potential cause of angioedema. For patients predisposed to nickel hypersensitivity, using nickel-free alternatives such as ceramic for orthodontic appliances is crucial. Additionally, comprehensive allergen screening, including latex testing, should be conducted before the placement of such devices to prevent similar adverse reactions.
血管性水肿是一种以皮下和黏膜下组织突然剧烈肿胀为特征的病症，通常与过敏反应、基因突变或药物反应有关。它也可能由接触镍等过敏原引起，进而导致皮炎。
一名12岁女孩因反复出现唇部血管性水肿一年多前来我们的儿科免疫学和过敏科就诊，这与食用豆类和西红柿以及使用金属长笛有关。尽管镍斑贴试验呈阳性，且随后避免接触镍，但她的症状仍持续存在。为排除血管性水肿的其他病因所做的进一步检查没有结果。后来发现她一年前佩戴了含镍的正畸装置。移除该正畸装置后血管性水肿发作停止，这表明镍可能是触发因素。
该病例强调了将牙科装置长期接触镍视为血管性水肿潜在病因的重要性。对于易对镍过敏的患者，使用无镍替代品（如陶瓷正畸器具）至关重要。此外，在放置此类装置前应进行全面的过敏原筛查，包括乳胶检测，以防止类似的不良反应。
