Bradykinin-mediated Angioedema

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Authors: Samuel Bergin, MD, University of Nevada School of Medicine

Davis Erickson MD, San Antonio Military Medical Center

Introduction:
The emergent management of angioedema presents as a challenge in the emergency department (ED). While the vast majority of cases are histamine-mediated allergic reactions, there remains a portion of cases mediated by bradykinin, which, do not respond to epinephrine, antihistamines, and steroids. Bradykinin-mediated angioedema broadly divides into three types: hereditary angioedema (HAE), angiotensin-converting enzyme inhibitor induced (ACEI-AAE), and acquired angioedema (Figure 1).[1-3]