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  Authority of Polish Society of Allergology

vol 20. no 2. June 2015  

 Review articles
Attacks of angioedema
Krystyna Obtułowicz, Anna Bogdali, Aleksander Obtułowicz, Jarosław Woroń

Attack of angioedema is a frequently occurring disorder, especially in
adults. It may appear with or without hives and itch. It may be idiopathic
or it may accompany other disorders.
They may be allergic, including IgE-related, in which histamine is the
major mediator, or non-Ige-related, mediated by other mediators, e.g.,
PAF. Allergic angioedema is provoked by food, insect venom, drug, or
allergic focal infection. They very often go with an itching and hives. Corticosteroids,
antihistaminics and adrenalin are drugs effectively removing
their symptoms.
The nonallergic angioedema, in contrast to allergic one, is usually induced
by bradykinin. This type of angioedema grows slowly. It is not accompanied
by itch and hives and it can reach large size. It disappears spontaneously
after 2-3 days. Bradykinin mediated angioedema is a consequence
of hereditary or acquired deficiency of C1 inhibitor or hyperactivity of
agglutination factor XII. It can appear also after intake of some drugs that
decrease inactivation of bradykinin. It is resistant for corticosteroids, antihistaminic
drugs or adrenaline and requires treatment with C1 inhibitor
drugs or inhibitor of B2 receptor of bradykinin, or fresh frozen plasma.
Bradykinin angioedema presents as subcutaneous external angioedema
or in submucosal membrane of internal organs (usually of the airways or
the digestive system). Bradykinin angioedema of the airways may be fatal
and requires immediate efficient medical treatment. However, bradykinin
angioedema of the digestive system also may be dangerous due to shock
provoked by hypovolemy and ache, or due to intestine occlusion.

keywords: obrzęk naczynioruchowy, bradykinina, histamina, angioedema, bradykinin, histamin

pages: from 73 to 78

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