Obstetric Anesthetic Management for Parturients with Hereditary Angioedema: A Case Report and Suggested Protocol

Clark, Kathryn J.; Sviggum, Hans P; Jacob, Adam K.; Arendt, Katherine W.; Volcheck, Gerald W.; Szymanski, Linda M.; Sharpe, Emily E.

doi:10.1093/pm/pnaa457

Cited by 2 publications

(1 citation statement)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Because there are not enough safety data on the potential effects of androgens on bone maturation, growth, and development, use of attenuated androgens is not recommended in children [51]. Moreover, pregnant females should not use androgen therapy because of adverse effects, while prophylactic use of plasma-derived C1 inhibitor concentrate was found to be effective in some cases [52,53]. Therefore, patients with HAE who are administered androgens long term should have regular physical examinations to adjust their medication regimen [1,31].…”

Section: Hypertensionmentioning

confidence: 99%

Long-term Prophylaxis with Androgens in the management of Hereditary Angioedema (HAE) in emerging countries

Guo

Zhang

et al. 2022

Orphanet J Rare Dis

View full text Add to dashboard Cite

Hereditary angioedema (HAE) is a rare autosomal dominant genetic disease characterized by repetitive subcutaneous or submucosal angioedema, activation of the kinin system, and increased vascular permeability. C1-inhibitor (C1-INH) deficiency, the main mechanism of HAE pathogenesis, occurs when abnormal activation of plasma kallikrein, bradykinin, and factor XII, or mutation of genes such as SERPING1 cause quantitative or functional C1-INH defects. Although androgens are not approved for HAE treatment in many countries, they are widely used in China and Brazil to reduce the frequency and severity of HAE attacks. The long-term adverse effects of androgen treatment are concerning for both physicians and patients. Virilization, weight gain, acne, hirsutism, liver damage, headache, myalgia, hematuria, menstrual disorders, diminished libido, arterial hypertension, dyslipidemia, and anxiety/depression are commonly observed during long-term treatment with androgens. These adverse effects can affect the quality of life of HAE patients and often lead to treatment interruption, especially in women and children. In-depth studies of the pathogenesis of HAE have led to the approval of alternative treatment strategies, including plasma-derived C1 inhibitor, recombinant human C1 inhibitor, plasma Kallikrein inhibitor (ecallantide; lanadelumab), and bradykinin B2 receptor antagonist (icatibant), some of which have achieved satisfactory results with mostly non-serious side effects. Therefore, a new standard of medical care may expand possibilities for the management of HAE in emerging countries.

show abstract