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'Nuts and Bolts' of Laboratory Evaluation of Angioedema
- Source :
- Clinical Reviews in Allergy & Immunology. 51:140-151
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- Angioedema, as a distinct disease entity, often becomes a clinical challenge for physicians, because it may cause a life-threatening condition, whereas prompt and accurate laboratory diagnostics may not be available. Although the bedside diagnosis needs to be established based on clinical symptoms and signs, family history, and the therapeutic response, later, laboratory tests are available. Currently, only for five out of the nine different types of angioedema can be diagnosed by laboratory testing, and these occur only in a minority of the patient population. Hereditary angioedema with C1-inhibitor (C1-INH) deficiency type I can be diagnosed by the low C1-INH function and concentration, whereas in type II, C1-INH function is low, but its concentration is normal or even elevated. C1q concentration is normal in both forms. Acquired angioedema with C1-INH deficiency type I is characterized by the low C1-INH function and concentration; however, C1q concentration is also low, and autoantibodies against C1-INH cannot be detected. Complement profile of acquired angioedema with C1-INH deficiency type II is similar to that of type I, but in this form, autoantibodies against C1-INH are present. Hereditary angioedema due to a mutation of the coagulation factor XII can be diagnosed exclusively by mutation analysis of FXII gene. Diagnostic metrics are not available for idiopathic histaminergic acquired angioedema, idiopathic non-histaminergic acquired angioedema, acquired angioedema related to angiotensin-converting enzyme inhibitor, and hereditary angioedema of unknown origin; these angioedemas can be diagnosed by medical and family history, clinical symptoms, and therapeutic response and by excluding the forms previously described. Several potential biomarkers of angioedema are used to date only in research. In the future, they could be utilized into the clinical practice to improve the differential diagnosis, therapy, as well as the prognosis of angioedema.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Allergy
C1-inhibitor
03 medical and health sciences
immune system diseases
medicine
Humans
Immunology and Allergy
cardiovascular diseases
Angioedema
Family history
skin and connective tissue diseases
Diagnostic Techniques and Procedures
biology
business.industry
Angioedemas, Hereditary
Autoantibody
food and beverages
General Medicine
medicine.disease
Dermatology
Phenotype
030104 developmental biology
Potential biomarkers
Immunology
Hereditary angioedema
biology.protein
Differential diagnosis
medicine.symptom
business
Algorithms
Biomarkers
Subjects
Details
- ISSN :
- 15590267 and 10800549
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- Clinical Reviews in Allergy & Immunology
- Accession number :
- edsair.doi.dedup.....cc9724b064fdf1881b3e5de3d244967b
- Full Text :
- https://doi.org/10.1007/s12016-016-8539-6