When faced with a patient with recurrent swelling, a thorough laboratory evaluation to determine the underlying etiology ensues. When the laboratory work-up is unrevealing, health care practitioners are frequently left in a quandary. This review will attempt to provide up-to-date information on how to approach the diagnosis and management of angioedema in a patient with normal laboratory values. The subtypes that will be reviewed in detail include: hereditary angioedema with normal C1 inhibitor (HAE with normal C1INH), drug-induced angioedema, and idiopathic angioedema. We present literature to aid the physician in the diagnosis and treatment of these disorders.
Here, we demonstrate that high levels of IL-33 and a high IL-33/soluble ST2 ratio correlates with elevated levels of IFN-γ, TNF-α and IL-17α as well as IL-5, demonstrating that IL-33 has pleiotropic effects. However, elevated IL-33 did not significantly impact lipid accumulation in macrophages overall. Given the wide variety of cellular responses regulated by IL-33, further investigation with a larger sample size will allow us to clarify the threshold concentration of IL-33 that leads to optimal cholesterol balance.
Adverse drug reactions occur commonly and primarily manifest in a myriad of cutaneous eruptions. The use of drug patch testing in the diagnosis of specific drug eruptions is increasing; however, a standardized approach to this methodology is currently lacking. A review of current literature was performed on the available evidence of patch testing for drugs. This review addresses the use of patch testing for specific cutaneous adverse drug reactions and for specific classes of drugs including antimicrobials, anticonvulsants, antiretrovirals, glucocorticoids, and nonsteroidal anti-inflammatory drugs. In addition, the approach to performing patch testing to drugs in the clinical arena as well as current contraindications for drug patch testing is reviewed.
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