Angioedema-Diagnosis & Management

Year : 2024 | Volume :14 | Issue : 02 | Page : 9-21
By

P.C Kathuria,

Manisha Rai,

  1. Senior Consultant Department of Chest and Allergy, BLK Super Speciality Hospital New Delhi India
  2. Associate Consultant Department of Allergy, National Allergy Centre New Delhi India

Abstract

Angioedema (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.

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

[This article belongs to Research & Reviews : A Journal of Immunology(rrjoi)]

How to cite this article: P.C Kathuria, Manisha Rai. Angioedema-Diagnosis & Management. Research & Reviews : A Journal of Immunology. 2024; 14(02):9-21.
How to cite this URL: P.C Kathuria, Manisha Rai. Angioedema-Diagnosis & Management. Research & Reviews : A Journal of Immunology. 2024; 14(02):9-21. Available from: https://journals.stmjournals.com/rrjoi/article=2024/view=167357

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Regular Issue Subscription Review Article
Volume 14
Issue 02
Received April 10, 2024
Accepted June 26, 2024
Published August 16, 2024
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