In Vitro Fertilization Using Luteinizing Hormone-Releasing Hormone Injections Resulted in Healthy Triplets without Increased Attack Rates in a Hereditary Angioedema Case

Dalgıç, Ceyda Tunakan; Günsen, Fatma Düşünür; Bulut, Gökten; Gökmen, Emine Nihal Mete; Sin, Aytül

doi:10.1155/2018/2706751

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…STP with pdC1-INH should be provided before IVF procedures that might trigger an attack, and C1-INH should be used on demand to treat an attack [ 24 ]. In a case report, prophylactic C1-INH was used successfully to prevent HAE-C1-INH attacks during IVF treatment and subsequently during pregnancy and delivery [ 62 ].…”

Section: Conception Planning In Women With Hae-c1-inhmentioning

confidence: 99%

Considerations in the management of hereditary angioedema due to C1-INH deficiency in women of childbearing age

Hsu

Lumry²,

Riedl

et al. 2022

Allergy Asthma Clin Immunol

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Hereditary angioedema (HAE) is a rare, autosomal disorder that manifests with unpredictable episodes of severe swelling of the skin and mucous membranes. These attacks can be highly disfiguring and range in severity from mild to—in cases of airway swelling—life-threatening. Fluctuations in female sex hormones—such as the changes that occur during puberty, menses, contraceptive use, pregnancy, and menopause—can all affect the frequency and severity of HAE attacks. Disease management decisions for women of childbearing age may be more complex and require additional considerations since they could develop complications related to contraception, pregnancy, labor, delivery, and lactation. In addition, some HAE treatment options are contraindicated during pregnancy. Discussions about medications used to treat HAE should include a risk–benefit assessment of the woman’s health status, her preferences, and other factors that are relevant to the choice of therapy. Planning prophylactic therapies that are effective and safe before, during, and after pregnancy can prevent gaps in treatment, ensure continuity of care, and reduce both disease burden and risk of adverse fetal outcomes. The 2020 US Hereditary Angioedema Association (HAEA) Medical Advisory Board and 2021 World Allergy Organization/European Academy of Allergy and Immunology (WAO/EAACI) Guidelines outline key considerations for managing HAE in females of childbearing age (15–45 years), with the goal of improving treatment efficacy and safety for this cohort of patients. Treatment decisions made in a collaborative manner involving the patient, HAE specialist and obstetric/gynecologic specialist, is the best approach to ensure optimal HAE management and safety in this patient population.

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Section: Conception Planning In Women With Hae-c1-inhmentioning

confidence: 99%

Considerations in the management of hereditary angioedema due to C1-INH deficiency in women of childbearing age

Hsu

Lumry²,

Riedl

et al. 2022

Allergy Asthma Clin Immunol

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“…51 She delivered healthy triplets by cesarean section without complications or increased attack rates. 51…”

Section: Fertility Treatmentmentioning

confidence: 99%

“…Banerji and Riedl 41 recommend that in vitro fertilization be performed during spontaneous cycle when estradiol levels are lower and less likely to cause hyperstimulation. There is a case report of a patient with HAE who underwent successful in vitro fertilization and received increased dose of prophylactic pdC1-INH during the time she received LHRH 51 . She delivered healthy triplets by cesarean section without complications or increased attack rates 51 …”

Section: Fertility Treatmentmentioning

confidence: 99%

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Hereditary Angioedema in Pregnancy

Binkley¹,

Betschel

2021

Obstetrical &Amp; Gynecological Survey

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Importance: Hereditary angioedema is a rare disease of potentially life-threatening attacks of angioedema that can affect patients of all ages, including women of childbearing age. Pregnancy can affect the course of the disease and the choice of treatment used. It is important for the care providers to recognize this disease and understand its mechanism in order to provide appropriate care for the patients.Objective: The goal of this article is to provide an overview of hereditary angioedema and guideline for management of pregnant patients with hereditary angioedema.Evidence Acquisition: A search of the available English language literature was performed on PubMed and Ovid MEDLINE using the key words hereditary angioedema and pregnancy. Additional articles were selected from the reference lists of the reviewed articles.Results: The data for hereditary angioedema in pregnant patients come from observational studies, case reports, retrospective reviews, and questionnaires. The course of hereditary angioedema can be variable between different patients and pregnancies. Plasma-derived C1 inhibitor concentrate is both safe and effective as treatment for attacks and as preventive therapy in pregnancy. With proper recognition, understanding of the disease, and appropriate medical management, most patients will undergo successful pregnancy and delivery.Conclusions and Relevance: Clinicians should maintain high suspicion for this disease when patients present with recurrent episodes of angioedema without urticaria or severe abdominal pains of unclear etiology. Treatment plans during pregnancy and delivery should be individualized, and the patient's care should be shared by a clinician experienced in the management of this disease.Target Audience: Obstetricians and gynecologists, family physicians Learning Objectives: After participating in this activity, the readers should be better able to identify the potential morbidity and mortality associated with hereditary angioedema; describe how hereditary angioedema can affect the care plan and outcome of pregnancy in affected patients, including labor and delivery; and explain what treatments are used in the management of hereditary angioedema during pregnancy.Hereditary angioedema (HAE) is often an underrecognized disease because of its rarity and overlapping features with other diseases that cause swelling. It is a disease of recurrent random attacks of painful swelling of subcutaneous and submucosal tissue, mainly mediated by a potent vasodilator bradykinin. 1 Unlike the more common histamine-mediated swelling in allergies and anaphylaxis, which respond to conventional treatment with epinephrine, antihistamine, or corticosteroids, angioedema due to bradykinin requires specific treatment targeting its pathway (Fig. 1). Bradykinin increases vascular permeability and causes local swelling, K.E.B. acted as consultant to CSL/Takeda. S.D.B. received advisory fee from CSL/Takeda. The remaining author, faculty, and staff in a position to control the content of this CME activity have...

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Experience with Intravenous Plasma-Derived C1-Inhibitor in Pregnant Women with Hereditary Angioedema: A Systematic Literature Review

Brooks

Radojicic

Riedl

et al. 2020

The Journal of Allergy and Clinical Immunology: In Practice

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In Vitro Fertilization Using Luteinizing Hormone-Releasing Hormone Injections Resulted in Healthy Triplets without Increased Attack Rates in a Hereditary Angioedema Case

Cited by 4 publications

References 14 publications

Considerations in the management of hereditary angioedema due to C1-INH deficiency in women of childbearing age

Considerations in the management of hereditary angioedema due to C1-INH deficiency in women of childbearing age

Hereditary Angioedema in Pregnancy

Experience with Intravenous Plasma-Derived C1-Inhibitor in Pregnant Women with Hereditary Angioedema: A Systematic Literature Review

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