The Definition, Acronyms, Nomenclature, and Classification of Angioedema: AAAAI, ACAAI, ACARE, and APAACI DANCE Consensus.

Angioedema acronyms classification terminology types

Journal

The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002

Informations de publication

Date de publication:
24 Apr 2024
Historique:
received: 28 11 2023
revised: 24 02 2024
accepted: 04 03 2024
medline: 27 4 2024
pubmed: 27 4 2024
entrez: 26 4 2024
Statut: aheadofprint

Résumé

Angioedema (AE) manifests with intermittent, localized, self-limiting swelling of the subcutaneous and/or submucosal tissue. AE is heterogeneous, can be hereditary or acquired, occurs only once or be recurrent, with or without wheals, due to mast cell mediators, bradykinin or other mechanisms. Currently, different taxonomic systems are used, making it difficult to compare the results of studies, develop multicenter collaboration, and harmonize treatments of AE patients. To develop a consensus on the definition, acronyms, nomenclature, and classification of angioedema (DANCE). The initiative involved 91 experts from 35 countries and was endorsed by 53 scientific, medical societies, and patient organizations. A consensus was reached by online discussion and voting using the Delphi process over a period of 16 months (June 2021 to November 2022). The DANCE initiative resulted in an international consensus on the definition, classification and terminology of AE. The new consensus classification features five types and endotypes of AE and a harmonized vocabulary of abbreviations and acronyms. The DANCE classification complements current clinical guidelines and expert consensus recommendations on the diagnostic workup and treatment of AE. DANCE does not replace current clinical guidelines and expert consensus algorithms and should not be misconstrued in a way that affects reimbursement of medicines prescribed by a physician using sound clinical judgment. We anticipate that the new AE taxonomy and nomenclature will harmonize and facilitate AE research and clinical studies, thereby improving patient care.

Sections du résumé

BACKGROUND BACKGROUND
Angioedema (AE) manifests with intermittent, localized, self-limiting swelling of the subcutaneous and/or submucosal tissue. AE is heterogeneous, can be hereditary or acquired, occurs only once or be recurrent, with or without wheals, due to mast cell mediators, bradykinin or other mechanisms. Currently, different taxonomic systems are used, making it difficult to compare the results of studies, develop multicenter collaboration, and harmonize treatments of AE patients.
OBJECTIVE OBJECTIVE
To develop a consensus on the definition, acronyms, nomenclature, and classification of angioedema (DANCE).
METHODS METHODS
The initiative involved 91 experts from 35 countries and was endorsed by 53 scientific, medical societies, and patient organizations. A consensus was reached by online discussion and voting using the Delphi process over a period of 16 months (June 2021 to November 2022).
RESULTS RESULTS
The DANCE initiative resulted in an international consensus on the definition, classification and terminology of AE. The new consensus classification features five types and endotypes of AE and a harmonized vocabulary of abbreviations and acronyms.
CONCLUSION CONCLUSIONS
The DANCE classification complements current clinical guidelines and expert consensus recommendations on the diagnostic workup and treatment of AE. DANCE does not replace current clinical guidelines and expert consensus algorithms and should not be misconstrued in a way that affects reimbursement of medicines prescribed by a physician using sound clinical judgment. We anticipate that the new AE taxonomy and nomenclature will harmonize and facilitate AE research and clinical studies, thereby improving patient care.

Identifiants

DOI: 10.1016/j.jaci.2024.03.024 PMID: 38670233
pubmed: 38670233
pii: S0091-6749(24)00407-X
doi: 10.1016/j.jaci.2024.03.024
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Avner Reshef (A)

Angioedema Research Center, Barzilai University Medical Center, Ashkelon, Israel. Electronic address: aresh@netvision.net.il.

Thomas Buttgereit (T)

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

Stephen D Betschel (SD)

Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

Teresa Caballero (T)

Department of Allergy, La Paz University Hospital, Hospital La Paz Institute for Health Research (IdiPAZ - Group 44), Biomedical Research Network on Rare Diseases (CIBERER U754), Madrid, Spain; NRC Institute of Immunology FMBA of Russia, Moscow, Russia.

Henriette Farkas (H)

Hungarian Angioedema Center of Reference and Excellence, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary.

Anete S Grumach (AS)

Clinical Immunology, University Center Faculdade de Medicina do ABC, Santo André, SP, Brazil.

Michihiro Hide (M)

Department of Dermatology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.

Ankur K Jindal (AK)

Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Hilary Longhurst (H)

Department of Medicine, University of Auckland and Department of Immunology, Auckland City Hospital, Auckland, New Zealand.

Jonathan Peter (J)

Division of Allergy and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.

Marc A Riedl (MA)

Division of Rheumatology, Allergy, and Immunology, University of California San Diego, La Jolla, California, USA.

Yuxiang Zhi (Y)

Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Werner Aberer (W)

Department of Dermatology, Medical University of Graz, Graz, Austria.

Mohamed Abuzakouk (M)

Allergy and Immunology, Respiratory Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.

Tariq Al Farsi (T)

Department of Pediatric allergy and clinical immunology, The Royal Hospital, Muscat, Oman.

Nashat Al Sukaiti (N)

Department of Pediatric allergy and clinical immunology, The Royal Hospital, Muscat, Oman.

Mona Al-Ahmad (M)

Microbiology Department, College of Medicine, Kuwait University.

Sabine Altrichter (S)

Klinik für Dermatologie und Venerologie, Kepler Uniklinikum, Linz, Austria.

Emel Aygören-Pürsün (E)

Department of Pediatrics, University Hospital Frankfurt, Goethe University Frankfurt, Germany.

Maria Luisa Baeza (ML)

Allergy Department, Hospital General Universitario Gregorio Marañón, Biomedical Research Network on Rare Diseases-U761, Institute for Health Research, Gregorio Marañón.

Noemi Anna Bara (NA)

Romanian Hereditary Angioedema Expertise Centre, Centrul Clinic Mediquest, Sangeorgiu de Mures, Romania.

Andrea Bauer (A)

Department of Dermatology, University Hospital Carl Gustav Carus, Technical University Dresden, Germany.

Jonathan A Bernstein (JA)

University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Rheumatology, Allergy and Immunology, Cincinnati, OH, USA.

Isabelle Boccon-Gibod (I)

National Reference Center of Angioedema CREAK, Grenoble, France.

Hanna Bonnekoh (H)

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

Laurence Bouillet (L)

National Reference Center of Angioedema CREAK, Grenoble, France; Internal medicine department, Grenoble university hospital, France.

Zenon Brzoza (Z)

Department of Internal Diseases with Division of Allergology, Institute of Medical Sciences, University of Opole, Opole, Poland.

Anette Bygum (A)

Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Clinical Institute, University of Southern Denmark, Odense, Denmark.

Oscar Calderon (O)

Clínica SANNA el Golf, San Isidro, Lima, Peru.

Regis de Albuquerque Campos (R)

Universidade Federal da Bahia, Brazilian Network of Hereditary Angioedema, Salvador, Bahia, Brazil.

Freya Helena Campos Romero (FH)

Department of Allergy and Clinical Immunology, Hospital Central Sur Alta Especialidad, Mexico City, Mexico City, Mexico.

Mauro Cancian (M)

Departmental Unit of Allergology, University Hospital of Padua, Padua, Italy.

Herberto Jose Chong-Neto (HJ)

Serviço de Alergia e Imunologia, Complexo Hospital de Clinicas, Universidade Federal do Paraná, Curitiba, Brazil.

George Christoff (G)

Excelsior Medical Centre, Sofia, Bulgaria; Medical University - Sofia, Bulgaria.

Stefan Cimbollek (S)

Hospital U. Virgen del Rocío, Sevilla, Spain.

Danny M Cohn (DM)

Amsterdam UMC, department of Vascular Medicine, Amsterdam Cardiovascular Sciences, University of Amsterdam, Amsterdam, the Netherlands.

Timothy Craig (T)

Department of Pediatrics, Pennsylvania State University, Hershey, Pennsylvania, USA.

Inna Danilycheva (I)

NRC Institute of Immunology FMBA of Russia, Moscow, Russia.

Razvigor Darlenski (R)

Department of dermatovenereology, Trakia University-Stara Zagora, Bulgaria.

Aurélie Du-Thanh (A)

ACARE, Département de dermatologie, Centre Hospitalier Universitaire de Montpellier; Montpellier, France.

Luis Felipe Ensina (LF)

Federal University of São Paulo,São Paulo, São Paulo, Brazil.

Daria Fomina (D)

Moscow City Research and Practical Center of Allergoloy and Immunology, Clinical Hospital No 52, Moscow Healthcare Department, Moscow, Russia.

Luz Fonacier (L)

New York University-Long Island School of Medicine, Mineola, New York, USA, Past President ACAAI.

Atsushi Fukunaga (A)

Department of Dermatology, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical and Pharmaceutical University.

Asli Gelincik (A)

Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Türkiye.

Pedro Giavina-Bianchi (P)

Division of Clinical lmmunology and Allergy, Universidade de São Paulo, São Paulo, São Paulo, Brazil.

Kiran Godse (K)

Dr. D. Y. Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India.

Mark Gompels (M)

ACARE, Department of Immunology, North Bristol NHS Trust, Bristol, United Kingdom.

Margarida Goncalo (M)

Department of Dermatology, Coimbra Hospital and University Center, and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.

Maia Gotua (M)

Center of Allergy and Immunology, Tbilisi, Georgia; David Tvildiani Medical University, Tbilisi, Georgia.

Guillermo Guidos-Fogelbach (G)

SEPI/ENMH Instituto Politecnico Nacional, Mexico City.

Mar Guilarte (M)

Allergy Department, Hospital Universitari Vall d'Hebron. Vall d'Hebron Research Institute (VHIR). Barcelona, Spain.

Alicja Kasperska-Zajac (A)

European Center for Diagnosis and Treatment of Urticaria and Angioedema and Department of Clinical Allergology and Urticaria, Medical University of Silesia in Katowice, Katowice, Poland.

Constance H Katelaris (CH)

Western Sydney University and Campbelltown Hospital.

Tamar Kinaciyan (T)

Department of Dermatology, Medical University of Vienna, Vienna, Austria.

Pavel Kolkhir (P)

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

Kanokvalai Kulthanan (K)

Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Marcin Kurowski (M)

Department of Immunology and Allergy, Medical University of Lodz, Poland.

Elena Latysheva (E)

NRC Institute of Immunology FMBA of Russia, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia.

Antti Lauerma (A)

Department of Dermatology, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.

David Launay (D)

Univ. Lille, Inserm, CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de référence des angioedemes à kinine (CREAK), U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France.

Ramon Lleonhart (R)

Allergology Department, Hospital Universitari Bellvitge, IDIBILL Research Institute. L'Hospitalet de Llobregat, Barcelona, Spain.

William Lumry (W)

AARA Research Center, Dallas, Texas, USA.

Alejandro Malbran (A)

Unidad de alergia, asma e inmunología clínica, Buenos Aires, Argentina.

Ramzy Mohammed Ali (RM)

Allergy and Immunology Division, Department of Medicine, Hamad Medical Corporation, Doha, Qatar.

Iman Nasr (I)

Immunology and Allergy department, The Royal Hospital, Muscat, Oman.

Sandra Nieto-Martinez (S)

Unidad de Genética de la Nutrición, Instituto Nacional de Pediatría, Mexico City, Mexico. Mexican Hereditary Angioedema Association. Latin American Hereditary Angioedema Association.

Claudio Parisi (C)

Pediatric and Adult Allergy Sections of the Italian Hospital of Buenos Aires.

Ruby Pawankar (R)

Nippon Medical School, Tokyo, Japan.

Macarena Piñero-Saavedra (M)

Allergy Department, Centro Hospitalar do Algarve, Faro, Portugal.

Todor A Popov (TA)

University Hospital Sv. Ivan Rilski, Sofia, Bulgaria.

Grzegorz Porebski (G)

Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Krakow, Poland.

Alicia Prieto Garcia (A)

Department of Allergy, Gregorio Marañón University Hospital, Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.

Polina Pyatilova (P)

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

Michael Rudenko (M)

The London Allergy and Immunology Centre, London, UK.

Bulent Enis Sekerel (BE)

Pediatric Allergy and Asthma Division, Hacettepe University, Ankara, Turkey.

Faradiba Sarquis Serpa (FS)

Angioedema and Urticaria Reference Center, Hospital Santa Casa de Misericórdia de Vitória, Vitória, Espirito Santo, Brazil.

Farrukh Sheikh (F)

Chughtai Medical Center, Lahore, Pakistan.

Frank Siebenhaar (F)

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

Angèle Soria (A)

Médecine Sorbonne Université, Service de Dermatologie et Allergologie, hôpital Tenon, Assistance Publique Hôpitaux de Paris, 4 rue de la Chine, 75020 Paris, France.

Maria Staevska (M)

Department of Allergology, Medical University of Sofia, Clinic of Allergology, University Hospital "Alexandrovska", Sofia, Bulgaria.

Petra Staubach (P)

ACARE, Department of Dermatology, University Medical Center Mainz, Germany.

Marcin Stobiecki (M)

Department of Clinical and Environmental Allergology, Jagiellonian University Medical College, Krakow, Poland.

Simon Francis Thomsen (SF)

Department of Dermato-Venereology, Bispebjerg Hospital, Copenhagen, Denmark.

Massimo Triggiani (M)

Division of Allergy and Clinical Immunology University of Salerno, Salerno, Italy.

Anna Valerieva (A)

Department of Allergology, Medical University of Sofia, Clinic of Allergology, University Hospital "Alexandrovska", Sofia, Bulgaria.

Solange Valle (S)

Department of Internal Medicine, Immunology Service.

Nguyen Van Dinh (N)

Respiratory - Allergy and Clinical Immunology Unit, Department of General Internal Medicine, Vinmec Healthcare System, Hanoi, Vietnam.

Carolina Elisa Vera Ayala (CE)

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

Anna Zalewska-Janowska (A)

Department of Psychodermatology, Chair of Pulmonology, Rheumatology and Clinical Immunology, Medical University of Lodz, Poland.

Andrea Zanichelli (A)

Department of Biomedical Sciences for Health, Universita degli Studi di Milano, Milan, Italy; Operative Unit of Medicine, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.

Markus Magerl (M)

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

Marcus Maurer (M)

Angioedema Center of Reference and Excellence (ACARE), Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine, and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.

Classifications MeSH