Classification and pathophysiology of angioedema

BackgroundThe classification of angioedema in daily clinical practice is often challenging.ObjectivesThe goal is to review the most recent classification of angioedema and to discuss the underlying pathology.Materials and methodsCurrent guidelines and research on the pathophysiology and classification of angioedema were evaluated.ResultsAngioedema is mast cell mediator-induced or bradykinin-mediated. Classic examples for mast cell mediator-induced angioedema are acute angioedema due to allergic reactions or acute urticaria as well as recurrent angioedema in chronic urticaria. Bradykinin-mediated angioedema forms include hereditary angioedema and angiotensin converting enzyme (ACE) inhibitor-induced angioedema. Bradykinin-mediated angioedema is less common than mast cell mediator-induced angioedema and often more severe. The diagnostic workup of angioedema patients includes agood medical history and subsequent laboratory testing.ConclusionsIn most cases, mast cell mediator-induced and bradykinin-mediated forms of angioedema are readily classified clinically and/or by laboratory tests. In very rare cases, however, the cause and mediators of angioedema remain unknown.