Notfall Angioödem

Angioödeme sind Schwellungen der tiefen Haut-/Schleimhautschichten und stellen im akuten Schub Notfallsituationen dar. Nach Stabilisierung der Vitalfunktionen sollte möglichst rasch eine ursachenorientierte Therapie erfolgen. Angioödeme werden durch Mastzellmediatoren (z. B. Histamin) und Störungen im Bradykinin-Stoffwechsel vermittelt. Nach der Lektüre dieses Beitrags kennen Sie die pathophysiologischen Unterschiede zwischen den einzelnen Angioödemformen, deren klinische Charakteristika und die möglichen Optionen für die symptomatische und Akuttherapie.

Abstract

Angioedemas are swellings of deep skin or mucosa layers and represent emergency situations in case of attacks. After stabilization of vital functions specific therapy should be induced as soon as possible. Angioedemas are driven by mast cell mediators (e.g. histamine) and pathologies in bradykinin metabolism. Key symptoms of histamine mediated types are wheals and pruritus. These types correspond well on epinephrine, antihistamines and corticosteroids in contrast to bradykinin mediated types. These in turn may be acquired (e.g. by ACE inhibitors) or hereditary (HAE). Treatment options in these cases are mainly C1 esterase inhibitor and icatibant as a bradykinin B2 receptor antagonist.

Schlüsselwörter

Histamin - Bradykinin - C1-Esterase-Inhibitor - erworbenes Angioödem - hereditäres Angioödem

Keywords

histamine - bradykinin - C1 esterase inhibitor - acquired angioedema - hereditary angioedema

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