Fresh Frozen Plasma in Hereditary Angioedema Crisis: To Give or Not To Give?

Abstract

Objectives: Fresh frozen plasma (FFP) has been used in angioedema crises, however there is a risk of aggravating the symptoms as well as transmitting infections. In this report, the authors emphasize the dangers of this therapy. Materials and methods:A 25-year-old woman with hereditary angioedema (HAE) was treated with FFP after which her symptoms escalated. Results: Administration of purified C1-inhibitor (C1-INH) resulted in relief of her symptoms. Conclusions: FFP is to be avoided in a HAE crisis. Newer therapies for angioedema are preferred.LEARNING POINTS • Angioedema should be considered when sudden onset facial edema is not associated with urticaria or pruritus, and does not improve with glucocorticoids and H1-antihistamines.• Fresh frozen plasma (FFP) is to be avoided in HAE crises as it can aggravate symptoms and carries the danger of transmitting infectious diseases; it can also induce allergic transfusion reactions, transfusion-related acute lung injury and circulatory overload.• Recombinant or human plasma-derived C1-inhibitor (C1-INH), icatibant or ecallantide are the first line treatments in hereditary angioedema attacks.