Vibratory angioedema: A hereditary type of physical hypersensitivity

doi:10.1016/0091-6749(72)90048-6

Journal of Allergy and Clinical Immunology

Volume 50, Issue 3, August 1972, Pages 174-182

https://doi.org/10.1016/0091-6749(72)90048-6 Get rights and content

Abstract

A new clinical entity has been termed vibratory angioedema (VA). This is inherited as a Mendelian-dominant characteristic. The manifestations consist of local erythematous and edematotis lesions following local stimuli of a vibratory or fractional nature. Marked local reactions are accompanied by facial or generalised erythema and headache. The systemic manifestations subsequent to intense local stimulation suggested the release of a vasoactive amine. Further evidence for this was provided by detection of elevated plasma amine levels in venous blood from an extremity following an appropriate stimulus. It was not established that this material was histamine or that it was an active participant in the local or systemic reaction. VA is a hereditary, immediate-type, nonimmunologic physical hypersensitivity reaction that may be associated with vasoactive mediator release.

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Cited by (69)

Physical urticaria: Clinical features, pathogenesis, diagnostic work-up, and management
2023, Journal of the American Academy of Dermatology
Physical urticaria is a type of urticaria in which recurrent wheals and/or angioedema occur following exposure of the skin to a physical stimulus. It is classified according to its triggers, which may be mechanical (friction, pressure, and vibration), thermal (cold and heat), or solar electromagnetic radiation. Symptoms of different physical urticarias can develop following specific activities that expose patients to an eliciting stimulus and may be variably accompanied by mucosal involvement and systemic symptoms, including nausea, headache, or even anaphylaxis. Differentiation of physical urticaria from other chronic urticarias requires careful clinical assessment and confirmatory provocation testing, which in turn can inform appropriate management. This clinical review provides an evidence-based summary of the epidemiology, clinical features, pathogenesis, diagnostic work-up, and management of physical urticaria.
[Translated article] Acquired Nonfamilial Vibratory Angioedema
2022, Actas Dermo-Sifiliograficas
Reply to “Proposal for a new classification of vibratory urticaria/angioedema”
2021, Journal of Allergy and Clinical Immunology: In Practice
Proposal for a new classification of vibratory urticaria/angioedema
2021, Journal of Allergy and Clinical Immunology: In Practice
Vibratory Angioedema Subgroups, Features, and Treatment: Results of a Systematic Review
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Citation Excerpt :
Serum tryptase level was increased in 1 of 413 patients with AVA (25%),3,6,10,13 but was negative in 2 of 2 patients with HVA.19 Serum histamine levels were increased in all 22 patients with VA investigated (4 patients with HVA5,19 and 18 patients with AVA9,15,16,26). Normal or negative results were reported from studies that performed the following blood tests: complete blood cell count,2,5,6,8,9,13,15,16,20,23 erythrocyte sedimentation rate,2,6,9,15,16 complement factor 3 level,2,8,9,15,20 complement factor 4 level,2,3,5,8,9,15,16,20,21 complement factor 1 esterase inhibitor level,2,3,5,8,16,20,21 serum IgE level,2,5,6,8,9,16 and antinuclear antibodies.9,16,20
Vibratory angioedema (VA) is a subtype of chronic inducible urticaria that manifests with erythematous wheals or angioedema after skin exposure to vibration. Because the condition is rare, the available information is limited.
To systematically review the clinical manifestations and treatment options of VA.
Relevant literature published until August 2020 was searched using the terms “vibratory urticaria,” “vibratory angioedema,” “vibratory-induced angioedema,” and “vibratory-induced urticaria.” Preferred Reporting Items for Systematic Reviews and Meta-analysis recommendations were applied to this systematic review.
On the basis of review of 22 studies (16 case reports, 4 case series, and 2 cohort studies) that had a combined total of 83 patients, we propose that VA be classified as hereditary VA (33.7%) and acquired VA (66.3%). Vibration-induced itching was frequent in both subgroups. Patients with hereditary VA more commonly had wheals and systemic symptoms, whereas patients with acquired VA more frequently had angioedema, burning, pain, or tingling. Although many VA treatments are used, there is little information on their efficacy. Most patients do not achieve complete control.
The novel VA classification proposed could help clinicians with the diagnostic workup of patients with VA. Because of the paucity of reported cases, firm recommendations for the treatment of VA are currently not possible. For patients with acquired VA, we suggest second-generation H₁-antihistamines as the first-line treatment. Controlled therapeutic trials are needed and should be performed.
Histaminergic Angioedema
2017, Immunology and Allergy Clinics of North America
Citation Excerpt :
Its causes are similar to those producing dermographism, including sitting for prolonged periods of time, tight clothing, or carrying heavy bags. Vibratory angioedema is the development of pruritus with subsequent angioedema (usually without urticaria) after exposure to a vibratory stimulus.34,35 Triggers include mowing the lawn, bicycle riding, or jack-hammering.

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^☆: Supported by United States Public Health Service Training Grant AI 00057 and the Ernest S. Bazley Grant to Chicago Wesley Memorial Hospital.

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Vibratory angioedema: A hereditary type of physical hypersensitivity☆

Abstract

A method for the fluorometric assay of histamine in tissues

J. Pharmacol. Exp. Ther

Anaphylaxis in chopped guinea pig lung. I. Effect of peptidase substrates and inhibitors

J. Exp. Med

The stoichiometric measurement of the serum inhibitor of the first component of complement by inhibition of immune hemolysis

J. Immunol

Measurement of IgE in normal and allergic serum by radioimmunoassay

J. Lab. Clin. Med