Hereditary angioedema: an update on causes, manifestations and treatment

Br J Hosp Med (Lond). 2019 Jul 2;80(7):391-398. doi: 10.12968/hmed.2019.80.7.391.

Abstract

Hereditary angioedema is a rare genetic disorder caused by deficiency of C1 esterase inhibitor (C1-INH) and characterized by recurrent episodes of severe swelling that affect the limbs, face, intestinal tract and airway. Since laryngeal oedema can be life-threatening as a result of asphyxiation, correct diagnosis and management of hereditary angioedema is vital. Hereditary angioedema attacks are mediated by bradykinin, the production of which is regulated by C1-INH. Hereditary angioedema therapy relies on treatment of acute attacks, and short- and long-term prophylaxis. Acute treatment options include C1-INH concentrate, icatibant and ecallantide. Self-administration of treatment is recommended and is associated with increased quality of life of patients with hereditary angioedema. Advances in diagnosis and management have improved the outcomes and quality of life of patients with hereditary angioedema.

Publication types

  • Review

MeSH terms

  • Bradykinin / analogs & derivatives
  • Bradykinin / metabolism
  • Bradykinin / therapeutic use
  • Complement C1 Inhibitor Protein / therapeutic use
  • Disease Progression
  • Factor XII / metabolism
  • Hereditary Angioedema Types I and II / classification
  • Hereditary Angioedema Types I and II / drug therapy*
  • Hereditary Angioedema Types I and II / physiopathology*
  • Hereditary Angioedema Types I and II / prevention & control
  • Humans
  • Kallikreins / metabolism
  • Peptides
  • Quality of Life

Substances

  • Complement C1 Inhibitor Protein
  • Peptides
  • ecallantide
  • icatibant
  • Factor XII
  • Kallikreins
  • Bradykinin