Angioedema is an acute swelling of the deeper layers of the skin or mucosa resulting from a transient increase in vascular permeability.
Angioedema can occur in the absence or presence of
hives, be hereditary or acquired, and be caused by various potential mediators, including
histamine and
bradykinin.
Bradykinin-mediated
angioedema can be difficult to diagnose but is responsible for a disproportionate percentage of the serious morbidity and mortality associated with
angioedema. Our understanding of the basic biology of
angioedema has dramatically expanded over recent years. The classification of
angioedema has correspondently undergone major changes. Optimal management of patients with
angioedema requires that an accurate diagnosis be established and that treatment be tailored to the patient's specific form of
angioedema. In this article, we review the biology of
bradykinin-mediated
angioedema as well as the clinical approach to the evaluation of
angioedema with a focus on
bradykinin-mediated
angioedema. Recognizing how the underlying pathophysiology and mechanisms of
bradykinin dysregulation contribute to
angioedema can help guide the clinical approach to the patient.