Diagnostic biologique des angioedèmes bradykiniques : les recommandations du CREAK

Presse Med. 2019 Jan;48(1 Pt 1):55-62. doi: 10.1016/j.lpm.2018.06.015. Epub 2018 Nov 8.
[Article in French]

Abstract

Bradykinin mediated angioedema (BK-AE) can be associated either with C1Inhibitor deficiency (hereditary and acquired forms), either with normal C1Inh (hereditary form and drug induced AE as angiotensin converting enzyme inhibitors…). In case of high clinical suspicion of BK-AE, C1Inh exploration must be done at first: C1Inh function and antigenemy as well as C4 concentration. C1Inh deficiency is significant if the tests are below 50 % of the normal values and controlled a second time. In case of C1Inh deficiency, you have to identify hereditary from acquired forms. C1q and anti-C1Inh antibody tests are useful for acquired BK-AE. SERPING1 gene screening must be done if a hereditary angioedema is suspected, even if there is no family context (de novo mutation 15 %). If a hereditary BK-AE with normal C1Inh is suspected, F12 and PLG gene screening is suitable.

Publication types

  • Practice Guideline

MeSH terms

  • Algorithms
  • Angioedema / chemically induced
  • Angioedema / metabolism
  • Angioedemas, Hereditary / classification
  • Angioedemas, Hereditary / metabolism*
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects
  • Bradykinin / metabolism*
  • Child
  • Comorbidity
  • Complement C1 Inhibitor Protein / analysis*
  • Complement C1 Inhibitor Protein / genetics
  • Early Diagnosis
  • Factor XII / physiology
  • Female
  • Fibrinolysin / physiology
  • Hematologic Diseases / epidemiology
  • Hereditary Angioedema Types I and II / diagnosis
  • Hereditary Angioedema Types I and II / metabolism
  • Humans
  • Kallikreins / physiology
  • Lupus Erythematosus, Systemic / epidemiology
  • Pregnancy
  • Pregnancy Complications / blood
  • Symptom Assessment

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Complement C1 Inhibitor Protein
  • SERPING1 protein, human
  • Factor XII
  • Kallikreins
  • Fibrinolysin
  • Bradykinin