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Pediatric Angioedema without Wheals: How to Guide the Diagnosis

Authors :
Lucia Liotti
Luca Pecoraro
Carla Mastrorilli
Riccardo Castagnoli
Francesca Saretta
Francesca Mori
Stefania Arasi
Simona Barni
Mattia Giovannini
Lucia Caminiti
Michele Miraglia Del Giudice
Elio Novembre
Source :
Life, Vol 13, Iss 4, p 1021 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

Angioedema (AE) is a vascular reaction of subcutaneous and submucosal tissues that identifies various clinical pictures and often is associated with wheals. AE without wheals (AEwW) is infrequent. The ability to distinguish between AEwW mediated by mast cells and bradykinin-mediated or leukotriene-mediated pathways is often crucial for a correct diagnostic–therapeutic and follow-up approach. AEwW can be hereditary or acquired. Factors typically correlated with hereditary angioedema (HAE) are a recurrence of episodes, familiarity, association with abdominal pain, onset after trauma or invasive procedures, refractoriness to antiallergic therapy, and lack of pruritus. The acquired forms of AE can present a definite cause based on the anamnesis and diagnostic tests. Still, they can also have an undetermined cause (idiopathic AE), distinguished according to the response to antihistamine in histamine-mediated and non-histamine-mediated forms. Usually, in childhood, AE responds to antihistamines. If AEwW is not responsive to commonly used treatments, it is necessary to consider alternative diagnoses, even for pediatric patients. In general, a correct diagnostic classification allows, in most cases, optimal management of the patient with the prescription of appropriate therapy and the planning of an adequate follow-up.

Details

Language :
English
ISSN :
20751729
Volume :
13
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Life
Publication Type :
Academic Journal
Accession number :
edsdoj.979d6b621e40a4b8246e3a8609f1ca
Document Type :
article
Full Text :
https://doi.org/10.3390/life13041021