Résumé
Background: activation of the coagulation cascade could be involved in the pathomechanism of angioedema (AE). This prospective, monocentric study aimed to determine a distinctive profile of the coagulation cascade in mast-cell mediated versus bradykinin-mediated AE. Materials and methods: mean levels of tissue factor (TF), activated factor VII and XII (FVIIa, FXIIa), D-Dimer (D-Di) and fibrinogen were measured during a crisis (C) or remission (R) in 4 groups of patients: bradykinin-mediated AE (Bk-AE), AE associated with superficial urticaria (Mast-AE), idiopathic isolated AE (IAE), chronic urticaria without AE (CU). Results: 28 patients (18 women), aged 19 to 76 years were included, with a male predominance only in the IAE group. Regarding mean levels of all factors, no significant difference could be found in the 4 groups. Mean levels of FVIIa and TF were increased only in the Bk-AE group. Mean levels of FXIIa were increased only in the Mast-AE and IAE groups. These data are contradictory with previously published data reporting isolated increase of FVIIa and TF (extrinsic pathway) in chronic urticaria patients versus activation of both the extrinsic and intrinsic (FXIIa) pathways in Bk-AE patients. Conclusion: this study with poor effectives failed to establish a distinctive profile of IAE, which may be biologically close to Mast-AE despite an unusual male predominance. Further studies on a larger number of patients and with a more detailed exploration of the coagulation cascade are required.