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P.C Kathuria, Manisha Rai,
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- Senior Consultant, Associate Consultant Department of Chest and Allergy, BLK Super Speciality Hospital, Department of Allergy, National Allergy Centre New Delhi, New Delhi India, India
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Abstract
nAngioedema (AE) encompasses a diverse range of conditions categorized into three main groups: (1) angioedema mediated by histamine (AE-H); (2) angioedema mediated by bradykinin (AE-BK); and (3) angioedema with an unknown mechanism (AE-UNK). It can manifest on any part of the body, though commonly affected areas include the face, lips, mouth, throat, larynx, extremities, genital regions, and gastrointestinal tract. AE-H can occur by itself or in conjunction with chronic urticaria, the acute form can be allergic due to food, drug, or insect bite related and patients often respond with antihistamines. Drug used angioedema is caused by increased production or decrease breakdown of vasoactive peptides, mainly bradykinin. Angiotensin converting enzyme inhibitor (ACE-I), Dipeptidase-IV (DPP-IV) inhibitor reduce the breakdown of bradykinin and substance P (SP). Hereditary angioedema (HAE) is defined by reduced functionality of the C1-inhibitor (C1-INH) protein, attributed to either its deficiency (Type I) or dysfunction (Type II). Additionally, there exist alternative types of HAE where C1-INH activity remains normal, yet the condition is linked to genetic mutations in different genes, such as factor XII. Acquired angioedema (AAE) can be distinguished from other types of angioedema; common in old age, a low functional & quantitative C1-INH level, Low C1q, presence of C1-esterase inhibitor antibodies and underlying lymphoproliferative diseases or both. There is a need for improved diagnostic methods for patients with idiopathic histaminergic acquired angioedema (IH-AAE), Idiopathic non-histaminergic acquired angioedema (InH-AAE), as well as angioedema induced by ACE inhibitors, and hereditary angioedema (HAE) with normal C1-INH levels. This review will discuss the classification, pathophysiology, and management of angioedema.
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Keywords: Angioedema (AE), angioedema mediated by histamine (AE-H), angioedema mediated by bradykinin (AE-BK), Histaminergic angioedema, bradykininergic angioedema, Hereditary angioedema (HAE), Acquired angioedema (AAE), unknown mechanism angioedema (AE-UNK), Idiopathic angioedema, C1-inhibitor, C1-INH, Icatibant, Ecallantide, tranexamic acid
n[if 424 equals=”Regular Issue”][This article belongs to Research & Reviews : A Journal of Immunology(rrjoi)]
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Volume | 14 | |
[if 424 equals=”Regular Issue”]Issue[/if 424][if 424 equals=”Special Issue”]Special Issue[/if 424] [if 424 equals=”Conference”][/if 424] | 02 | |
Received | April 10, 2024 | |
Accepted | June 26, 2024 | |
Published | August 16, 2024 |
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