Drug-induced angioedema: an update on new cases and new drugs

Introduction: drug-induced angioedema is a transient swelling of the subcutaneous layer of the skin or submucosal layer of the respiratory or gastrointestinal tracts. These drugs decrease the activity of the enzyme responsible for the degradation of bradykinin, which is then overproduced causing vasodilation and increased permeability. The aim of this piece of research is to identify descriptions of new drugs that can induce angioedema, in light of the latest scientific discoveries. Materials and methods: a bibliographic research was conducted using keyword “angioedema druginduced ” limited to human race, identifying 267 articles in the last 5 years (2012-2016). Exclusion criterias were applied and the data obtained was organized in a database. The overall sample is composed of 5.387 patients who have had angioedema and are reported in 12 articles; in 4.732 cases angioedema is due to one (or more) drugs. Results: the average age of patients with angioedema is 65 +/11 years, with a slight predominance of the female gender. Some of these patients were already hospitalized, generally in Critical Care Units such as the Stroke Unit; some others were directly hospitalized from the Emergency Room. Discussion: evidence has shown bradykinin playing a crucial role in the pathogenesis of most forms of non-allergic angioedema, while histamine acts as the major biological mediator in allergic angioedema, with urticaria, rash and flushing, and bronchocostriction. This review highlights the need of training for both emergency physicians in Emergency Departments, and nurses in Triage stations on the diagnosis of this disease that, whilst rare, may be induced by several drugs, whose