Recurrent angioedema: diagnosis strategy and biological aspects.
The aetiologies of recurrent angioedema (AE) comprise the frequent histaminergic AE and the rare bradykinin-mediated AE. Diagnosis must be done carefully because they do not have the same treatment. Diagnosis strategy is clinical. The most specific symptoms for bradykinin AE are: isolated AE without wheals, long duration of the attack, abdominal localisation. The unique useful biological tests for the diagnosis of bradykinin AE are C1Inh exploration which is altered in hereditary AE (HAE) types I and II. No other biological test is useful in clinical practice at present. In case of suspicion of bradykinin AE with normal C1Inh, physicians must think of drug-induced AE. Hereditary AE with normal C1Inh may be associated with a mutation on gene F12 in 20% of cases. For 80% of patients without mutation, the diagnosis must be done very carefully.
National Reference Centre for Angioedema (CREAK), Internal medicine department, Grenoble University Hospital, BP 217 38043 Grenoble cedex 09 France, Unité Inserm 1036, CEA, Université de médecine Joseph-Fourier, Grenoble, France.
Laurence
L
Bouillet
National Reference Centre for Angioedema (CREAK), Internal medicine department, Grenoble University Hospital, BP 217 38043 Grenoble cedex 09 France.
Isabelle
I
Boccon-Gibod
Université Lyon1, Immunology and Allergy Clinic, Inserm U1111-CIRI, CHU Lyon Sud, 69495 Pierre-Bénite, France.
Frédéric
F
Berard
Université Lyon1, Immunology and Allergy Clinic, Inserm U1111-CIRI, CHU Lyon Sud, 69495 Pierre-Bénite, France.
Jean-François
JF
Nicolas
D000799:Angioedema / Q000175:diagnosis* / Q000209:etiology; D001920:Bradykinin / Q000502:physiology; D006632:Histamine / Q000502:physiology; D006801:Humans; D012008:Recurrence
D006632:Histamine; D001920:Bradykinin
C1Inh; angioedema; bradykinin; diagnosis; histamine; urticaria