Angioedema

Luisa María Holguín-Gómez, Luz Adriana Vásquez-Ochoa, Ricardo Cardona

Resumen


El angioedema se define como el edema de piel o mucosas, incluidas las de los tractos respiratorio y gastrointestinal, de carácter autolimitado, que en la mayoría de los casos se resuelve en forma completa en menos de 72 horas. Ocurre por aumento de la permeabilidad de los capilares mucosos, submucosos y vénulas poscapilares, con la consiguiente extravasación del plasma. Existen diferentes tipos de angioedema: el histaminérgico (que puede ser mediado o no por inmunoglobulina E), el hereditario, por déficit de C1 inhibidor adquirido, por inhibidores de la enzima convertidora de la angiotensina, mediados por bradiquininas y el angioedema no histaminérgico idiopático. El tratamiento depende de la causa del angioedema, la edad, frecuencia y gravedad de sus manifestaciones. Las principales medidas son evitar los desencadenantes o disparadores externos, la administración de antihistamínicos, esteroides o adrenalina en el angioedema histaminérgico; el reemplazo de la proteína deficiente o el bloqueo de la acción de la bradiquinina en el déficit de C1 inhibidor y en el angioedema por inhibidores de la enzima convertidora de la angiotensina. 


Palabras clave


Angioedema; Histamina; Bradiquininas; Angioedema idiopático; Urticaria; Antiinflamatorios no esteroideos; Ciclooxigenasa

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Referencias


Kaplan AP. Angioedema. World Allergy Organ J. 2008;1(6):103-113. doi:10.1097/ WOX.0b013e31817aecbe

Mansi M, Zanichelli A, Coerezza A, Suffritti C, Wu MA, Vacchini R, et al. Presentation, diagnosis and treatment of angioedema without wheals: a retrospective analysis of a cohort of 1058 patients. J Intern Med. 2015 May;277(5):585-593. doi: 10.1111/joim.12304

Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA2LEN/ EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: The 2013 revision and update. Allergy Eur J Allergy Clin Immunol. 2014;69(7):868-887. doi:10.1111/all.12313

Kaplan AP, Greaves M. Pathogenesis of chronic urticaria. Clin Exp Allergy. 2009;39(6):777-787. doi:10.1111/j.1365-2222.2009.03256.x.

Wu MA, Perego F, Zanichelli A, Cicardi M. Angioedema phenotypes: Disease expression and classification. Clin Rev Allergy Immunol. 2016;51(2):1-8. doi:10.1007/s12016-016-8541-z

Mahendran K, Padmini G, Murugesan R, Srikumar A. Acute allergic angioedema of upper lip. J Conserv Dent. 2016;19(3):285. doi:10.4103/0972-0707.181949

Temiño VM, Peebles RS. The spectrum and treatment of angioedema. Am J Med. 2008;121(4):282-286. doi:10.1016/j.amjmed.2007.09.024

Abbas AK, Lichtman AH, Pillai S. Cellular and molecular immunology. Atlanta, GA, USA: Elsevier; 2014.

Jares EJ, Sánchez-Borges M, Cardona-Villa R, Ensina LF, Arias-Cruz A, Gómez M, et al. Multinational experience with hypersensitivity drug reactions in Latin America. Ann Allergy, Asthma Immunol. 2014;113(3):282-289. doi:10.1016/j.anai.2014.06.019

Torres MJ, Barrionuevo E, Kowalski M, Blanca M. Hypersensitivity reactions to non-steroidal anti-inflammatory drugs. Immunol Allergy Clin North Am. 2014;34:507-524. doi:10.1016/j.iac.2014.04.001

Cornejo-García JA, Blanca-López N, Dona I, Andreu I, Agúndez JA, Carballo M, et al. Hypersensitivity reactions to non-steroidal anti-inflammatory drugs. Curr Drug Metab. 2009;10(9):971-980. doi:10.1016/j. iac.2014.04.001

Adkinson NF, Bochner BS, Burks W, Busse, William W, Holgate ST, et al. Middleton’s allergy principles and practice. Octava edición. Atlanta, GA, USA: Elsevier; 2014.

Abajian M, Mlynek A, Maurer M. Physical urticaria. Curr Allergy Asthma Rep. 2012;12(4):281-287. doi:10.1007/s11882-012-0269-0

Magerl M, Altrichter S, Borzova E, Giménez-Arnau A, Grattan CEH, Lawlor F, et al. The definition, diagnostic testing and management of chronic inducible urticarias. Update and revision of the EAACI/ GA2LEN/EDF/UNEV 201 consensus recommendations 2016 update and revision. Allergy. 2016;71:780- 702. doi:10.1111/all.12884

Parra V, Darío-Aguirre H, Daza RA, Mora SA, Peñaranda E. Lupus eritematoso sistémico versus urticaria vasculítica hipocomplementémica: un dilema diagnóstico en la práctica clínica. Rev Colomb Reumatol. 2015;22(3):168-173.

Chang S, Carr W. Urticarial vasculitis. Allergy Asthma Proc. 2007;28(1):97-100. doi:10.2500/aap.2007.28.2972

Pulido-Pérez A, Avilés-Izquierdo JA, Suárez-Fernández R. Vasculitis cutáneas. Actas Dermosifiliogr. 2012;103(3):179-191. doi:10.1016/j.ad.2011.06.00.

Maitra A. Endocrine system. En: Kumar V, Abbas AK, Aster JC, editores. Robbins basic pathology. Novena edición. Philadelphia: Elsevier Saunders; 2013. p. 715-764.

Tacconelli S, Capone ML, Patrignani P. Clinical pharmacology of novel selective COX-2 inhibitors. Curr Pharm Des. 2004;10(6):589-601. doi:10.2174/1381612043453108

Cryer B, Feldman M. Cyclooxygenase-1 and cyclooxygenase-2 selectivity of widely used nonsteroidal anti-inflammatory drugs. Am J Med. 1998;104(5):413-421. doi:10.1016/S0002-9343(98)00091-6

Lee RU, Stevenson DD. Aspirin-exacerbated respiratory disease: evaluation and management. Allergy Asthma Immunol Res. 2011;3(1):3. doi:10.4168/aair.2011.3.1.3.

Kowalski ML, Woessner K, Sanak M. Approaches to the diagnosis and management of patients with a history of nonsteroidal anti-inflammatory drug-related urticaria and angioedema. J Allergy Clin Immunol. 2015;136(2):245-251. doi:10.1016/j.jaci.2015.06.021.

Kowalski ML, Asero R, Bavbek S, Blanca M, Blanca-López N, Bochenek G, et al. Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs. Allergy Eur J Allergy Clin Immunol. 2013;68(10):1219-1232. doi:10.1111/all.12260.

Milewski M, Mastalerz L, Nizankowska E, Szczeklik A. Nasal provocation test with lysine-aspirin for diagnosis of aspirin-sensitive asthma. J Allergy Clin Immunol. 1998;101(5):581-586. doi:10.1016/S0091- 6749(98)70163-0

Nizankowska E, Bestynska-Krypel A, Cmiel A, Szczeklik A. Oral and bronchial provocation tests with aspirin for diagnosis of aspirin-induced asthma. Eur Respir J. 2000;15(5):863-869.

Nizankowska-Mogilnicka E, Bochenek G, Mastalerz L, Swierczyńska M, Picado C, Scadding G, et al. EAACI/GA2LEN guideline: aspirin provocation tests for diagnosis of aspirin hypersensitivity. Allergy. 2007;62(10):1111-1118. doi:10.1111/j.1398-9995.2007.01409.x

Macy E, Bernstein JA, Castells MC, Gawchik SM, Lee TH, Settipane RA, et al. Aspirin challenge and desensitization for aspirin-exacerbated respiratory disease: a practice paper. Ann Allergy Asthma Immunol. 2007;98(2):172-174. doi:10.1016/S1081-1206(10)60692-8

Asero R. Oral aspirin challenges in patients with a history of intolerance to single non-steroidal anti-inflammatory drugs. Clin Exp Allergy. 2005;35(6):713-716. doi:10.1111/j.1365-2222.2005.2228.x

Barbaud A. Drug patch testing in systemic cutaneous drug allergy. Toxicology. 2005;209(2):209-216. doi:10.1016/j.tox.2004.12.024.

Barbaud A, Goncalo M, Bruynzeel D, Bircher A. Guidelines for performing skin tests with drugs in the investigation of cutaneous adverse drug reactions. Contact Dermatitis. 2001;45(6):321-328.

Cugno M, Zanichelli A, Foieni F, Caccia S, Cicardi M. C1-inhibitor deficiency and angioedema: molecular mechanisms and clinical progress. Trends Mol Med. 2009;15(2):69-78. doi:10.1016/j.molmed.2008.12.001

Zeerleder S, Levi M. Hereditary and acquired C1-inhibitor-dependent angioedema: from pathophysiology to treatment. Ann Med. 2016;3890:1-12. doi:10.3109/07853890.2016.1162909

Craig TJ, Pürsün EA, Bork K, Bowen T, Boysen H, Farkas H, et al. WAO Guideline for the management of hereditary angioedema. World Allergy Organ J. 2012;5(12):182-199. doi:10.1097/ WOX.0b013e318279affa

Riedl MA. Hereditary angioedema with normal C1-INH (HAE Type III). J Allergy Clin Immunol Pract. 2013;1(5):427-432. doi:10.1016/j.jaip.2013.06.004.

Drouet C, Désormeaux A, Robillard J, Ponard D, Bouillet L, Martin L, et al. Metallopeptidase activities in hereditary angioedema: Effect of androgen prophylaxis on plasma aminopeptidase P. J Allergy Clin Immunol. 2008;121(2):429-433. doi:10.1016/j.jaci.2007.10.048

Davis AE 3rd. The pathophysiology of hereditary angioedema. Clin Immunol. 2005;114(1):3-9.

Walford HH, Zuraw BL. Current update on cellular and molecular mechanisms of hereditary angioedema. Ann Allergy Asthma Immunol. 2014;112(5):413-418. doi:10.1016/j.anai.2013.12.02

Atkinson JP, Cicardi M, Zuraw BL, Saini S FA. Hereditary angioedema: Epidemiology, clinical manifestations, exacerbating factors, and prognosis. UpToDate. 2014:1-11.

Bork K, Wulff K, Hardt J, Witzke G, Staubach P. Hereditary angioedema caused by missense mutations in the factor XII gene: Clinical features, trigger factors, and therapy. J Allergy Clin Immunol. 2009;124(1):129-134. doi:10.1016/j.jaci.2009.03.038

Cicardi M, Aberer W, Banerji A, Bas M, Bernstein JA, Bork K, et al. Classification, diagnosis, and approach to treatment for angioedema: Consensus report from the Hereditary Angioedema International Working Group. Allergy. 2014;69(5):602-616. doi:10.1111/all.12380

Scalese MJ, Reinaker TS. Pharmacologic management of angioedema induced by angiotensin-converting enzyme inhibitors. Am J Heal Pharm. 2016;73(12):873-879. doi:10.2146/ajhp150482

Wilkerson RG. Angioedema in the emergency department: an evidence-based review. Emerg Med Pract. 2012;14(11):1-21.

Church MK, Maurer M, Simons FER, Bindslev-Jensen C, van Cauwenberge P, Bousquet J, et al. Risk of first-generation H(1)-antihistamines: A GA(2)LEN position paper. Allergy Eur J Allergy Clin Immunol. 2010;65(4):459-466. doi:10.1111/j.1398-9995.2009.02325.x

Staevska M, Popov TA, Kralimarkova T, Lazarova C, Kraeva S, Popova D, et al. The effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J Allergy Clin Immunol. 2010;125(3):676-682. doi:10.1016/j.jaci.2009.11.047

Krause K, Spohr A, Zuberbier T, Church MK, Maurer M. Up-dosing with bilastine results in improved effectiveness in cold contact urticaria. Allergy Eur J Allergy Clin Immunol. 2013;68(7):921-928.

Tubert-Brohman I, Sherman W, Repasky M, Beuming T. Improved docking of polypeptides with glide. J Chem Inf Model. 2013;53(7):1689-1699. doi: 10.1021/ci400128m

Spector SL, Tan RA. Effect of omalizumab on patients with chronic urticaria. Ann Allergy Asthma Immunol. 2007;99(2):190-193. doi:10.1016/S1081-1206(10)60644-8

Büyüköztürk S, Gelincik A, Demirtürk M, Kocaturk E, Çolakoǧlu B, Dal M. Omalizumab markedly improves urticaria activity scores and quality of life scores in chronic spontaneous urticaria patients: A real life survey. J Dermatol. 2012;39(5):439-442. doi:10.1111/j.1346-8138.2011.01473.x

Metz M, Altrichter S, Ardelean E, Kessler B, Krause K, Magerl M, et al. Anti-immunoglobulin E treatment of patients with recalcitrant physical urticaria. Int Arch Allergy Immunol. 2011;154(2):177-180.

Nurnberg W, Grabbe J, Czarnetzki BM. Urticarial vasculitis syndrome effectively treated with dapsone and pentoxifylline. Acta Derm Venereol. 1995;75(1):54-56.

Wiles JC, Hansen RC, Lynch PJ. Urticarial vasculitis treated with colchicine. Arch Dermatol. 1985;121(6):802-805. doi:10.1001/archderm.1985.01660060116035.

Lopez LI, Davis KC, Kohler PF, Schocket AL. The hypocomplementemic urticarial-vasculitis syndrome: therapeutic response to hydroxychloroquine. J Allergy Clin Immunol. 1984;73(5 Pt 1):600-603.

Caballero T, Baeza ML, Cabañas R, Campos A, Cimbollek S, Gómez-Traseira C, et al. Consensus statement on the diagnosis, management, and treatment of angioedema mediated by bradykinin. Part I. Classification, epidemiology, pathophysiology, genetics, clinical symptoms, and diagnosis. J Investig Allergol Clin Immunol. 2011;21(5):333-347.

Bowen T, Cicardi M, Bork K, Zuraw B, Frank M, Ritchie B, et al. Hereditary angiodema: A current state-of-the-art review, VII: Canadian Hungarian 2007 International Consensus Algorithm for the Diagnosis, Therapy, and Management of Hereditary Angioedema. Ann Allergy, Asthma Immunol. 2008;100(1):S30-S40. doi:10.1016/S1081-1206(10)60584-4

Bowen T, Cicardi M, Farkas H, Bork K, Kreuz W, Zingale L, et al. Canadian 2003 International Consensus Algorithm for the Diagnosis, Therapy, and Management of Hereditary Angioedema. J Allergy Clin Immunol. 2004;114(3):629-637. doi:10.1016/j.jaci.2004.06.043

Gompels MM, Lock RJ, Abinun M, Bethune CA, Davies G, Grattan C, et al. C1 inhibitor deficiency: Consensus document. Clin Exp Immunol. 2005;139(3):379-394. doi:10.1111/j.1365-2249.2005.02726.x

Charignon D, Ghannam A, Defendi F, Ponard D, Monnier N, López Trascasa M, et al. Hereditary angioedema with F12 mutation: Factors modifying the clinical phenotype. Allergy. 2014;69(12):1659- 1665. doi: 10.1111/all.12515

Charignon D, Späth P, Martin L, Drouet C. Icatibant, the bradykinin B2 receptor antagonist with target to the interconnected kinin systems. Expert Opin Pharmacother. 2012;13(15):2233-2247. doi:10.1517/146 56566.2012.723692

Cicardi M, Banerji A, Bracho F, Malbrán A, Rosenkranz B, Riedl M, et al. Icatibant, a new bradykinin-receptor antagonist, in hereditary angioedema. N Engl J Med. 2010;363(6):532-541. doi:10.1056/ NEJMoa0906393

Lumry WR, Li HH, Levy RJ, Potter PC, Farkas H, Moldovan D, et al. Randomized placebo-controlled trial of the bradykinin B2 receptor antagonist icatibant for the treatment of acute attacks of hereditary angioedema: The FAST-3 trial. Ann Allergy Asthma Immunol. 2011;107(6):529-537. doi:10.1016/j. anai.2011.08.015

Czaller I, Visy B, Csuka D, Füst G, Tóth F, Farkas H. The natural history of hereditary angioedema and the impact of treatment with human C1-inhibitor concentrate during pregnancy: A long-term survey. Eur J Obstet Gynecol Reprod Biol. 2010;152(1):44-49. doi:10.1016/j.ejogrb.2010.05.008

Craig TJ, Levy RJ, Wasserman RL, Bewtra AK, Hurewitz D, Obtułowicz K, et al. Efficacy of human C1 esterase inhibitor concentrate compared with placebo in acute hereditary angioedema attacks. J Allergy Clin Immunol. 2009;124(4):801-808. doi:10.1016/j.jaci.2009.07.017

Craig TJ, Bewtra AK, Bahna SL, Hurewitz D, Schneider LC, Levy RJ, et al. C1 esterase inhibitor concentrate in 1085 hereditary angioedema attacks-final results of the I.M.P.A.C.T.2 study. Allergy Eur J Allergy Clin Immunol. 2011;66(12):1604-1611. doi:10.1111/j.1398-9995.2011.02702.x

Xu YY, Buyantseva LV, Agarwal NS, Olivieri K, Zhi YX, Craig TJ. Update on treatment of hereditary angioedema. Clin Exp Allergy. 2013;43(4):395-405. doi:10.1111/cea.12080

Riedl M, Campion M, Horn PT, Pullman WE. Response time for ecallantide treatment of acute hereditary angioedema attacks. Ann Allergy, Asthma Immunol. 2010;105(6):430-436.e2. doi:10.1016/j. anai.2010.09.005

Sheffer AL, Campion M, Levy RJ, Li HH, Horn PT, Pullman WE. Ecallantide (DX-88) for acute hereditary angioedema attacks: Integrated analysis of 2 double-blind, phase 3 studies. J Allergy Clin Immunol. 2011;128(1):153-159. doi:10.1016/j.jaci.2011.03.006




DOI: http://dx.doi.org/10.29262/ram.v63i4.220

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