Phenotype standardisation of angioedema in the head and neck region caused by agents acting on the angiotensin system

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Clinical Pharmacology & Therapeutics accepted article preview 24 June 2014; doi: 10.1038/clpt.2014.138

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Mia Wadelius¹, Sara E Marshall², Gunilla Islander³, Leif Nordang⁴, Malgorzata Karawajczyk⁵, Qun-Ying Yue⁶, Ingrid Terreehorst⁷, Ekaterina V. Baranova⁸, Svante Hugosson⁹, Karin Sköldefors¹⁰, Munir Pirmohamed¹¹, Anke-Hilse Maitland van der Zee⁸, Ana Alfirevic¹¹, Pär Hallberg¹ and Colin N.A. Palmer²

1. ¹Department of Medical Sciences, Clinical pharmacology, Uppsala University, Uppsala, Sweden
2. ²Medical Research Institute, College of Medicine Dentistry and Nursing, University of Dundee, Ninewells Hospital Dundee, UK
3. ³Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden
4. ⁴Department of Surgical Sciences, Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
5. ⁵Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
6. ⁶Medical Products Agency, Uppsala, Sweden
7. ⁷Academic Medical Center, Amsterdam, The Netherlands
8. ⁸Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands
9. ⁹Department of Otorhinolaryngology, Örebro University Hospital and Örebro University, Örebro, Sweden.
10. ¹⁰Department of Otorhinolaryngology, Hudiksvall hospital, Hudiksvall, Sweden
11. ¹¹Department of Molecular & Clinical Pharmacology, University of Liverpool, Liverpool, UK.

Correspondence: Mia Wadelius, Department of Medical Sciences, Clinical pharmacology, Uppsala University, Uppsala University Hospital entrance 61 3^rd floor, SE-751 85 Uppsala, Sweden. T: +46 18 611 4945, M: +46 7 3982 3905, F: +46 18 55 25 62, E: mia.wadelius@medsci.uu.se

Received 27 March 2014; Accepted 18 June 2014
Accepted article preview online 24 June 2014

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Abstract

Angioedema is a potentially life-threatening adverse reaction to angiotensin converting enzyme inhibitors and angiotensin receptor blockers. To study the genetic etiology of this rare adverse event, international consortia and multicentre recruitment of patients are needed. To reduce patient heterogeneity, we have standardised the phenotype. In brief, it comprises swelling in the head and neck region that first occurs during treatment. It should not coincide with urticaria or have another likely cause such as hereditary angioedema.

Keywords: 

Drug-Related Side Effects and Adverse Reactions; Angioedema; Renin-Angiotensin System; Angiotensin-Converting Enzyme Inhibitors; Angiotensin Receptor Antagonists; Phenotype; Reference Standards

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