Local bradykinin generation in hereditary angioedema,☆☆,

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METHODS

In 2 patients with acute forearm angioedema resulting from hereditary C1-inhibitor deficiency, we measured bradykinin in blood samples taken simultaneously from the edematous area and from the contralateral unaffected forearm. Plasma bradykinin was measured specifically by radioimmunoassay after liquid-phase extraction and subsequent high-performance liquid chromatography as recently described in detail.5 The detection limit was 0.2 fmol/mL. Both intra-assay and interassay coefficients of

RESULTS AND DISCUSSION

We found clearly increased concentrations of venous plasma bradykinin in the edematous forearm compared with the contralateral control arm (77 versus 9.5 fmol/mL and 46 versus 16 fmol/mL, respectively, with normal reference levels at 2.2 ± 2.2 fmol/mL) (Fig 1).

. Bradykinin concentrations in 2 patients with hereditary deficiency of C1 inhibitor during an episode of brachial angioedema. Bradykinin plasma levels were increased in systemic circulation, but the blood draining from the affected arm

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    Citation Excerpt :

    With this regard, some evidence exists about local generation of bradykinin, with possible local activation of the kinin-releasing system by rarely identified triggers (physical trauma, oral surgery. etc), as demonstrated by higher BK levels in the venous compartment of the affected limb as compared to those of the unaffected limb [86]. This is consistent with the usual absence of hypotension during HAE attacks.

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Reprint requests: Angelo Agostoni, MD, Department of Internal Medicine, University of Milan, Via Pace, 15, 20122 Milan, Italy.

☆☆

J Allergy Clin Immunol 1999;104:1321-2.

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