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Pediatric Angioedema without Wheals: How to Guide the Diagnosis

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-m...

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Autores principales: Liotti, Lucia, Pecoraro, Luca, Mastrorilli, Carla, Castagnoli, Riccardo, Saretta, Francesca, Mori, Francesca, Arasi, Stefania, Barni, Simona, Giovannini, Mattia, Caminiti, Lucia, Miraglia Del Giudice, Michele, Novembre, Elio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141554/
https://www.ncbi.nlm.nih.gov/pubmed/37109550
http://dx.doi.org/10.3390/life13041021
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author Liotti, Lucia
Pecoraro, Luca
Mastrorilli, Carla
Castagnoli, Riccardo
Saretta, Francesca
Mori, Francesca
Arasi, Stefania
Barni, Simona
Giovannini, Mattia
Caminiti, Lucia
Miraglia Del Giudice, Michele
Novembre, Elio
author_facet Liotti, Lucia
Pecoraro, Luca
Mastrorilli, Carla
Castagnoli, Riccardo
Saretta, Francesca
Mori, Francesca
Arasi, Stefania
Barni, Simona
Giovannini, Mattia
Caminiti, Lucia
Miraglia Del Giudice, Michele
Novembre, Elio
author_sort Liotti, Lucia
collection PubMed
description 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.
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spelling pubmed-101415542023-04-29 Pediatric Angioedema without Wheals: How to Guide the Diagnosis Liotti, Lucia Pecoraro, Luca Mastrorilli, Carla Castagnoli, Riccardo Saretta, Francesca Mori, Francesca Arasi, Stefania Barni, Simona Giovannini, Mattia Caminiti, Lucia Miraglia Del Giudice, Michele Novembre, Elio Life (Basel) Perspective 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. MDPI 2023-04-15 /pmc/articles/PMC10141554/ /pubmed/37109550 http://dx.doi.org/10.3390/life13041021 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Perspective
Liotti, Lucia
Pecoraro, Luca
Mastrorilli, Carla
Castagnoli, Riccardo
Saretta, Francesca
Mori, Francesca
Arasi, Stefania
Barni, Simona
Giovannini, Mattia
Caminiti, Lucia
Miraglia Del Giudice, Michele
Novembre, Elio
Pediatric Angioedema without Wheals: How to Guide the Diagnosis
title Pediatric Angioedema without Wheals: How to Guide the Diagnosis
title_full Pediatric Angioedema without Wheals: How to Guide the Diagnosis
title_fullStr Pediatric Angioedema without Wheals: How to Guide the Diagnosis
title_full_unstemmed Pediatric Angioedema without Wheals: How to Guide the Diagnosis
title_short Pediatric Angioedema without Wheals: How to Guide the Diagnosis
title_sort pediatric angioedema without wheals: how to guide the diagnosis
topic Perspective
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141554/
https://www.ncbi.nlm.nih.gov/pubmed/37109550
http://dx.doi.org/10.3390/life13041021
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