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  Authority of Polish Society of Allergology

vol 18. no 4. December 2013  

 Review articles
Isolated angioedema - pathogenesis, diagnosis and principles of treatment
Bernard Panaszek

Angioedema usually is accompanied urticaria, with which it shares the pathogenesis, but in 10% of cases the swelling is not accompanied by hives. It is not clear why, in isolated angioedema, mediators are released only in the deeper layers of the skin and mucous membranes. It seems, however, that in addition to the main mediator, i.e. histamine, also other mediators participate in the formation of an edema. Those mediators are found in abundance in effector cells (mast cells, eosinophils, platelets, endothelial cells), and generated as a result of activation of the coagulation (Hageman factor), the complement (anaphylatoxins), the kinin-forming (bradykinin), and the fibrinolysis (plasmin) systems. Angiotensin converting enzyme inhibitor - (ACEi) - induced angioedema, as well as that associated with the inherited or acquired pathology of the inhibitor of the first constituent of the complement - C1-INH, represent isolated swelling. In contrast to urticaria, isolated angioedema is a transient phenomenon and never occurs in the chronic form. However, until now, the cause of isolated angioedema remains unknown in most cases of diagnosed idiopathic angioedema. Antihistamines are most effective in the treatment of allergic angioedema, but play a lesser role in the treatment of angioedema associated with C1-INH deficiency and ACE-blocking drugs.

keywords: obrzęk naczynioruchowy, C1- INH, ACEi, bradykinina,plazmina, czynniki kontaktu, angioedema, C-1 INH, ACEi, bradykinin, plasmin, contactfactors

pages: from 213 to 220

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