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[What are angioedemas and how are they classified?]
1Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum Schleswig-Holstein, Universität zu Lübeck, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland. Andreas.Recke@uksh.de.
Background:
The term angioedema refers both to a clinical symptom, i.e., a self-limiting swelling of the deep dermis, subcutis or submucosa and also to a group of diseases with heterogeneous etiology and pathophysiology. This heterogeneity makes a precise mechanistic classification a prerequisite for the diagnostics and treatment.
Methods:
A narrative review is given based on the definition, acronyms, nomenclature, and classification of angioedema (DANCE) classification published in 2024 and current consensus documents.
Results:
The DANCE classification divides angioedema into five mechanistically oriented categories: mast cell-mediated (AE-MC), bradykinin-mediated (AE-BK), vascular-endothelial (AE-VE), drug-induced (AE-DI) and angioedema of unknown cause (AE-UNK). The currently most critical clinical decision point is the distinction between mast cell-mediated and bradykinin-mediated forms, as the acute treatment and long-term management are fundamentally different.
Conclusion:
The DANCE classification represents an important step towards further harmonization of the international terminology of angioedema and provides a structured basis for the diagnostics, research and treatment; however, further research is needed with respect to the functional validation of individual endotypes.
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