Abstract：
BACKGROUND: Problems in the definition and classification of angioedema, leading to difficulties in its diagnosis and treatment, have been identified; therefore, an improvement in the current classification of angioedema is required.
OBJECTIVE: The aim of this study was to propose a practical classification of angioedema without wheals that helps to establish a differential diagnosis and take appropriate therapeutic decisions.
METHODS: An initial proposal of classification of angioedema without wheals was agreed by a scientific committee of experts and was subsequently validated by a panel of experts by means of consensus based on the Delphi methodology. Forty-five items on the classification, diagnosis, and treatment of angioedema without wheals were proposed for the survey.
RESULTS: Most items (93.8%) were agreed after two rounds. All panelists agreed with the proposed classification, as well as with most of the clinical and treatment characteristics. The angioedema without wheals classification established three groups: histamine-mediated, bradykinin-mediated, and unknown mechanism angioedema. The clinical characteristics of the proposed types of angioedema were also agreed, except for the allergic histamine-mediated and unknown mechanism angioedema, which generated debate. Regarding treatments, although there was broad agreement with the proposed items, a lack of knowledge about some treatments in this pathology was observed.
CONCLUSIONS: The proposed classification of angioedema without wheals was accepted with a high degree of agreement; however, knowledge of available treatments needs to be increased and the definition of angioedema of unknown mechanism needs to be improved.
OBJECTIVE: The aim of this study was to propose a practical classification of angioedema without wheals that helps to establish a differential diagnosis and take appropriate therapeutic decisions.
METHODS: An initial proposal of classification of angioedema without wheals was agreed by a scientific committee of experts and was subsequently validated by a panel of experts by means of consensus based on the Delphi methodology. Forty-five items on the classification, diagnosis, and treatment of angioedema without wheals were proposed for the survey.
RESULTS: Most items (93.8%) were agreed after two rounds. All panelists agreed with the proposed classification, as well as with most of the clinical and treatment characteristics. The angioedema without wheals classification established three groups: histamine-mediated, bradykinin-mediated, and unknown mechanism angioedema. The clinical characteristics of the proposed types of angioedema were also agreed, except for the allergic histamine-mediated and unknown mechanism angioedema, which generated debate. Regarding treatments, although there was broad agreement with the proposed items, a lack of knowledge about some treatments in this pathology was observed.
CONCLUSIONS: The proposed classification of angioedema without wheals was accepted with a high degree of agreement; however, knowledge of available treatments needs to be increased and the definition of angioedema of unknown mechanism needs to be improved.
摘要：
背景：血管性水肿的定义和分类中的问题，导致其诊断和治疗困难，已被识别；因此，目前血管性水肿的分类需要改进.
目的：本研究的目的是提出无风团血管性水肿的实用分类，以帮助建立鉴别诊断和采取适当的治疗决策。
方法：专家科学委员会同意了无风团血管性水肿分类的初步建议，随后由专家小组通过基于Delphi方法的共识进行了验证。分类上的45个项目，诊断,并建议治疗无风团的血管性水肿。
结果：大多数项目（93.8%）在两轮后达成一致。所有小组成员都同意拟议的分类，以及大部分的临床和治疗特点。没有风团分类的血管性水肿建立了三组：组胺介导的，缓激肽介导的，和不明机制的血管性水肿。所提出的血管性水肿类型的临床特征也是一致的，除了过敏性组胺介导的和未知机制的血管性水肿，这引发了辩论。关于治疗,尽管对拟议的项目有广泛的一致意见，观察到缺乏关于这种病理学的一些治疗方法的知识。
结论：建议的无风团血管性水肿分类被高度一致接受；然而，需要增加对可用治疗方法的了解,并且需要改进对未知机制的血管性水肿的定义.
目的：本研究的目的是提出无风团血管性水肿的实用分类，以帮助建立鉴别诊断和采取适当的治疗决策。
方法：专家科学委员会同意了无风团血管性水肿分类的初步建议，随后由专家小组通过基于Delphi方法的共识进行了验证。分类上的45个项目，诊断,并建议治疗无风团的血管性水肿。
结果：大多数项目（93.8%）在两轮后达成一致。所有小组成员都同意拟议的分类，以及大部分的临床和治疗特点。没有风团分类的血管性水肿建立了三组：组胺介导的，缓激肽介导的，和不明机制的血管性水肿。所提出的血管性水肿类型的临床特征也是一致的，除了过敏性组胺介导的和未知机制的血管性水肿，这引发了辩论。关于治疗,尽管对拟议的项目有广泛的一致意见，观察到缺乏关于这种病理学的一些治疗方法的知识。
结论：建议的无风团血管性水肿分类被高度一致接受；然而，需要增加对可用治疗方法的了解,并且需要改进对未知机制的血管性水肿的定义.
