Fuente: PubMed "hive" Allergol Immunopathol (Madr). 2026 Jul 1;54(4):151-155. doi: 10.15586/aei.v54i4.1651. eCollection 2026.ABSTRACTBACKGROUND: Mast cell-mediated angioedema (MC-AE) is an increasingly recognized entity in pediatric allergy, distinct from bradykinin-mediated and allergic angioedema. Despite its clinical relevance, pediatric data remain limited and classification remains challenging in the absence of validated biomarkers.OBJECTIVE: To describe the clinical presentation, diagnostic workup, and therapeutic outcomes of a pediatric case series with recurrent MC-AE without wheals.METHODS: A retrospective review was conducted comprising pediatric patients with recurrent angioedema without urticaria, evaluated at a tertiary pediatric allergy unit in Barcelona between January 2021 and November 2024. Inclusion required ≥2 episodes, no wheals, and follow-up ≥12 months. Data collected included demographics, clinical features, laboratory evaluation, treatment response, and outcomes.RESULTS: Seven children (six females, median age at onset 6 years) met inclusion criteria. All had superficial, well-demarcated, self-limiting angioedema, most commonly periorbital. C1-inhibitor studies were normal, excluding hereditary angioedema. All responded to high-dose second-generation antihistamines; corticosteroids were used transiently in moderate/severe episodes. No patients required biologics or hospital admission. Basophil activation was positive in 1/6 tested patients. Episode frequency decreased during follow-up.CONCLUSION: Pediatric MC-AE appears to represent a clinically identifiable phenotype characterized by recurrent superficial swelling, normal complement testing, and consistent antihistamine responsiveness. These findings support mechanism-oriented classification frameworks and highlight the importance of timely recognition to optimize management.PMID:42433064 | DOI:10.15586/aei.v54i4.1651