Ting S, Reimann B E, Rauls D O, Mansfield L E
J Allergy Clin Immunol. 1983 Jun;71(6):546-51. doi: 10.1016/0091-6749(83)90435-9.
Vibratory angioedema is a rare form of physical angioedema. A Mexican-American boy presented with vibration-related prolonged angioedema of the hands at age 16. After the use of a controlled vibratory stimulus, 10 volunteers and seven members of the family (three generations) developed expected transient erythema and whealing reaction of the skin at the site of contact. However, with the same vibrating stimulus the patient developed large erythematous swelling that lasted for 12 hr. Vibratory challenge study revealed a rapid rise and fall in plasma histamine. No increase in levels of plasma histamine were detected from the nonstimulated arm. Prausnitz-Küstner testing was negative. Light and electron microscopic study of the mast cell revealed degranulation and extensive fragmentation of the granules from the stimulated site. No degranulation was seen in the contralateral unstimulated site. A state of tolerance to vibration was induced by graded increased exposure to vibratory stimulus and the patient's clinical problem was eliminated.
振动性血管性水肿是物理性血管性水肿的一种罕见形式。一名墨西哥裔美国男孩在16岁时出现与振动相关的手部持续性血管性水肿。在使用受控振动刺激后，10名志愿者和7名家族成员（三代人）在接触部位出现预期的短暂皮肤红斑和风团反应。然而，在相同的振动刺激下，该患者出现了持续12小时的大片红斑肿胀。振动激发试验显示血浆组胺迅速升高和下降。未受刺激的手臂未检测到血浆组胺水平升高。被动转移试验为阴性。对肥大细胞的光镜和电镜研究显示，受刺激部位的肥大细胞脱颗粒且颗粒广泛破碎。对侧未受刺激部位未见脱颗粒现象。通过逐渐增加对振动刺激的暴露诱导出对振动的耐受状态，患者的临床问题得以消除。
