Exogenous oestrogen as an alternative to food allergy in the aetiology of angioneurotic oedema

André, Fabrice; Veysseyre-Balter, Cécile; Rousset, H.; Descos, L; André, C.

doi:10.1016/s0300-483x(02)00584-x

Cited by 17 publications

(15 citation statements)

References 9 publications

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“…In 22 women discontinuation of oral contraception induced C1-INH level and increased activity. These were associated with recovery and marked improvement of clinical symptoms, formerly attributed to food allergy [65]. Based on this study, it has been suggested that exogenous estrogens, such as those contained in most oral contraceptives, may play an iatrogenic role in aetiology of chronic angioneurotic oedema or urticaria [65].…”

Section: Oral Contraceptives and Hormone Replacement Therapymentioning

confidence: 95%

Sex hormones and urticaria

Kasperska−Zając

Brzoza

Rogala

2008

Journal of Dermatological Science

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Section: Oral Contraceptives and Hormone Replacement Therapymentioning

confidence: 95%

Sex hormones and urticaria

Kasperska−Zając

Brzoza

Rogala

2008

Journal of Dermatological Science

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“…However, an association between urticaria and likely BK-AO has already been reported in a population very similar to the population presented here. André et al [11 ]reported a series of 26 women with AO and urticaria (n = 24) or urticaria only (n = 2) initially attributed to food allergy. All these female patients were in fact taking oral contraception (ethinyloestradiol 35 µg and cyproterone acetate 2 mg in 11 cases) and had a slightly decreased C1-Inh function.…”

Section: Discussionmentioning

confidence: 99%

“…C1-Inh functional deficiency and electrophoretic abnormality were reversible after the causal contraceptive was discontinued. André et al [11 ]also reported a female population receiving oral contraceptives suffering from AO and/or urticaria with a moderate deficiency of C1-Inh function. Discontinuation of oral contraception led to the resolution or improvement of the symptoms in 20 of the 22 patients.…”

Section: Introductionmentioning

confidence: 99%

Angio-Oedema Induced by Oestrogen Contraceptives Is Mediated by Bradykinin and Is Frequently Associated with Urticaria

Giard

Nicolie²,

Drouet³

et al. 2012

Dermatology

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Background: Hereditary C1-inhibitor (C1-Inh) deficiency is associated with ‘bradykinin-mediated angio-oedema’ (BK-AO) and is believed not to be associated with urticaria. Acquired AO has been related to oestrogen contraceptives. Objective: To demonstrate that AO precipitated by oestrogens and characterized by nonfunctional C1-Inh is mediated by BK and to evaluate the occurrence of urticaria in these patients. Methods: A retrospective evaluation of patients referred for AO related to oestrogen was undertaken. Circulating C1-Inh, high molecular weight kininogen (HK) and enzymes involved in the metabolism of bradykinin were investigated. Results: Fifteen patients were included. HK cleavage concurrent to oestrogen intake was demonstrated in 10 patients with available plasma. Eight patients reported recurrent or chronic urticaria. Discontinuation of the contraceptive resulted in a return to native C1-Inh and HK in all cases studied and to normal kininogenase activity in all but one. The clinical manifestations completely disappeared in 6 patients and improved in 7 after the withdrawal of oestrogen. Conclusion: Patients display extensive cleavage of HK in the plasma, which supports that AO precipitated by oestrogen contraception is BK-mediated. Recurrent urticaria may have been underestimated in this context. The presence of recurrent urticaria should not systematically rule out the diagnosis of BK-AO when the history is suggestive.

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“…Urticaria, defined as pruritic, freely mobile and transient erythematous papules or plaques, was not an exclusion criterion provided that patient history and presentation were otherwise suggestive of BK-AO. We and others have in fact observed that the association - whether synchronous or not - with urticaria does not allow to systematically rule out the diagnosis of BK-AO [15,26,27,28,29] (fig. 1).…”

Section: Methodsmentioning

confidence: 99%

Distinct Conditions Support a Novel Classification for Bradykinin-Mediated Angio-Oedema

Dessart

Defendi²,

Humeau³

et al. 2015

Dermatology

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Background: Angio-oedema (AO) can be attributable to bradykinin (BK) accumulation, as is the case for prototypical hereditary AO (HAO) due to C1 inhibitor (C1-INH) deficiency. However, our clinical experience in a reference centre has shown that some patients display a clinical history suggestive of HAO, but exhibit normal C1-INH function, have no mutation in the causative genes associated with HAO (SERPING1, F12), and report no intake of drugs known to promote AO. Objective: We sought to determine the frequency and distribution of different AO subtypes suspected to be BK-mediated AO (BK-AO) and defined by clinical, history and biological criteria (enzyme activities implicated in BK formation and catabolism). Methods: The files of all patients referred to our centre for suspected BK-AO were retrospectively analysed. Results: The distribution of patients (n = 162) was 16 and 4% with a hereditary deficiency of C1-INH or a gain of factor XII function, respectively, 29% with iatrogenic BK-AO, 21% with non-iatrogenic defective kininase activity and 30% with idiopathic increased kinin formation. Conclusion: BK-AO may be caused by multiple inherited or acquired factors triggering BK accumulation. Therefore, we propose a novel typology for BK-AO based on the imbalance of production/catabolism of BK.

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Exogenous oestrogen as an alternative to food allergy in the aetiology of angioneurotic oedema

Cited by 17 publications

References 9 publications

Sex hormones and urticaria

Sex hormones and urticaria

Angio-Oedema Induced by Oestrogen Contraceptives Is Mediated by Bradykinin and Is Frequently Associated with Urticaria

Distinct Conditions Support a Novel Classification for Bradykinin-Mediated Angio-Oedema

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