ace/angioedema definition
Bradykinin is the mediator of angioedema associated with angiotensin-converting enzyme (ACE) inhibitors that prevent bradykinin destruction so that levels rise. The source of bradykinin formation can either be the plasma or tissue bradykinin-forming pathways. Practice Essentials. Angioedema is the swelling of deep dermis, subcutaneous, or submucosal tissue due to vascular leakage.Acute episodes often involve the lip, eyes, and face (see the image below); however, angioedema may affect other parts of body, including respiratory and gastrointestinal (GI) mucosa. Angioedema caused by ACE inhibitors is a classic example of bradykinin-mediated angioedema. HAE, AAE, estrogen-dependent angioedema, and certain forms of idiopathic angioedema are also bradykinin-mediated. Antihistamines do not work for these patients, and corticosteroids have limited or no value. Angioedema, first described in 1586,is usually defined by pronounced swelling of the deep dermis, subcutaneous or submucosal tissue, or mucous membranes as a result of vascular leakage.Other terms, such as giant urticaria,Quincke edema,and angioneurotic edema,have also been used in the past to describe this condition. In the former case, angioedema can be caused by allergic reactions caused by immunoglobulin E (IgE)-mediated hypersensitivity to foods or drugs that can also result in acute urticaria or a more generalized anaphylactic reaction. If the patient is taking an ACE inhibitor, this drug should be stopped. Even if the patient is not taking an ACE inhibitor, these drugs should be avoided in the future. Consider addition of tranexamic acid for higher-dose antihistamine-resistant angioedema. Angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors treat a variety of conditions, such as high blood pressure, scleroderma and migraines. Angiotensin-converting enzyme (ACE) inhibitors help relax blood vessels. ACE inhibitors prevent an enzyme in your body from producing angiotensin II, a substance in your body that narrows your blood vessels and releases hormones that can raise your blood pressure. This narrowing can cause high blood pressure and force your heart to work harder. Patients with moderate to severe angioedema often present to the emergency department (ED). Epinephrine should be used when laryngeal angioedema is suspected. Supportive care (eg, pain control) should also be provided, regardless of the etiology. Angioedema refers to abrupt nonpitting swelling of the skin, mucous membranes, or both, including the upper respiratory and gastrointestinal tracts, which typically lasts from many hours to 3 days. The involved tissues then return to normal. Sites of predilection include the face, hands, feet, and genitalia.
Angioedema is the swelling of deep dermis, subcutaneous, or submucosal tissue due to vascular leakage.