Palabras clave
Histamina
Bradiquininas
Angioedema idiopático
Urticaria
Antiinflamatorios no esteroideos
Ciclooxigenasa
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.
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