Risk of laryngeal edema and facial swellings after tooth extraction in patients with hereditary angioedema with and without prophylaxis with C1 inhibitor concentrate: a retrospective study

Bork, Konrad; Hardt, Jochen; Staubach‐Renz, Petra; Witzke, Guenther

doi:10.1016/j.tripleo.2011.02.034

Cited by 125 publications

(126 citation statements)

References 31 publications

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“…Thus, depending on the kind of procedure and on the patients' history of previous HAE attacks, a course of shortterm prophylaxis (STP) may be planned when appropriate. The efficacy of pdC1-INH in STP has been shown to be dosedependent in retrospective evaluations of dental procedures and other types of surgery [66,67]. Danazol may be considered an alternative to pd-C1-INH for STP.…”

Section: Prophylaxis Of Attacksmentioning

confidence: 99%

Novelties in the Diagnosis and Treatment of Angioedema

Cicardi¹,

Suffritti²,

Perego³

et al. 2016

J Investig Allergol Clin Immunol

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Angioedema is defined as local, noninflammatory, self-limiting edema that is circumscribed owing to increased leakage of plasma from the capillaries located in the deep layers of the skin and the mucosae. Two mediators, histamine and bradykinin, account for most cases of angioedema. Angioedema can occur with wheals as a manifestation of urticaria, and this form is frequently allergic. In the present review, we discuss nonallergic angioedema without wheals, which can be divided into 3 acquired and 4 hereditary forms. Histamine is the mediator in acquired angioedema of unknown etiology (idiopathic histaminergic acquired angioedema), whereas in other forms the main mediator is bradykinin. Angioedema can be caused by C1-inhibitor deficiency (C1-INH-hereditary angioedema and C1-INH-acquired angioedema), mutations in coagulation factor XII (FXII-hereditary angioedema), and treatment with angiotensin-converting enzyme inhibitors (ACEI-acquired angioedema). Etiology remains unclear in acquired angioedema (idiopathic nonhistaminergic acquired angioedema) and in 1 type of hereditary angioedema (hereditary angioedema of unknown origin). Several treatments are licensed for hereditary C1-INH deficiency. Plasma-derived and recombinant C1-INHs, the bradykinin receptor blocker icatibant, and the plasma kallikrein inhibitor ecallantide have been approved for on-demand treatment to reverse angioedema symptoms. Attenuated androgen and plasma-derived C1-INH are approved for prophylaxis. Key words: Angioedema. Bradykinin. Histamine. C1 inhibitor. Coagulation factor XII. Angiotensin-converting enzyme inhibitors. Urticaria. ResumenAngioedema se define como un edema local, autolimitado, no-inflamatorio. Se trata de un edema circunscrito debido a la trasvasación de plasma de los capilares localizados en los sustratos profundos de la piel y de las mucosas. En la mayoría de los casos están implicados dos mediadores, la histamina y la serotonina. Puede manifestarse en forma de habones como en la urticaria de origen alérgico. El angioedema de origen no alérgico es el motivo de esta revisión. Se puede presentar bajo 3 formas adquiridas y 4 formas hereditarias. La histamina es el mediador implicado en el angioedema adquirido de etiología desconocida (angioedema adquirido idiopático histaminérgico). En las otras formas se sospecha que es la serotonina el mediador principal. La etiología del angioedema puede ser identificado en 4 tipos: una deficiencia de C1-inhibidor (C1-INH-angioedema hereditario y C1-INH-angioedema adquirido), mutaciones en el factor XII de coagulación (FXII-angioedema hereditario), tratamiento con inhibidores del enzima convertidor de la angiotensina (ACEi-angioedema adquirido). En uno de los adquiridos (angioedema adquirido idiopático no histaminérgico) y en el hereditario de origen desconocido, no se ha identificado todavía su etiología. Varios tratamientos están aprobados para revertir los síntomas clínicos y se aplican en la deficiencia de angioedema hereditario por déficit de C1-INH: Derivados de plasma y C1-IN...

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Section: Prophylaxis Of Attacksmentioning

confidence: 99%

Novelties in the Diagnosis and Treatment of Angioedema

Cicardi¹,

Suffritti²,

Perego³

et al. 2016

J Investig Allergol Clin Immunol

View full text Add to dashboard Cite

show abstract

“…Moreover, a single patient could present or not present AE after the same procedure [70][71][72]. There are no controlled studies that assess STP efficacy; current available data come from observational studies: The risk of perioperative AE without STP (not taking into account dental procedures) is 6-31% [73].…”

Section: Recombinant Human C1 Inhibitormentioning

confidence: 99%

“…There is no increased risk related to the procedure location or surgical area size [73]. The prevalence of AE attacks after dental procedures performed without STP varies from 5 to 37% of patients [71][72][73]. Farkas et al observed that 40% of the patients who had not performed STP developed AE post-procedures, when assessing all the interventions as a whole [74].…”

Section: Recombinant Human C1 Inhibitormentioning

confidence: 99%

“…The study of STP use in large patients' series has shown that STP with pdhC1INH or AAs reduced the number of patients who present AE attacks after medical/surgical procedures [15,71,73]. pdhC1INH reduced the AE risk more after invasive procedures than AAs and AAs more than tranexamic acid [73].…”

Section: Recombinant Human C1 Inhibitormentioning

confidence: 99%

“…pdhC1INH reduced the AE risk more after invasive procedures than AAs and AAs more than tranexamic acid [73]. It is important to emphasize that the AE risk after surgical/medical procedures is not completely avoided with STP [71,73] and is independent of C1-INH-HAE severity [15] and thus, at least one therapeutic dose of a specific treatment for acute AE attacks should be available during and after the procedure [8,74]. If the procedure involves the ENT area, the patient should be informed about the possibility to develop a laryngeal oedema, not only in the 12 hours following the procedure but also later [72], and one should establish an action plan for the patient.…”

Section: Recombinant Human C1 Inhibitormentioning

confidence: 99%

See 2 more Smart Citations

Short‐Term Prophylaxis in Odontostomatological, Maxillofacial and ENT Procedures in Patients with Hereditary Angioedema Due to C1‐Inhibitor Deficiency

Palomo¹,

Caballero²

2017

A Comprehensive Review of Urticaria and Angioedema

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Oestrogens, trauma, infections or stress has been described as triggers for angioedema (AE) attacks in patients with hereditary angioedema due to C1-inhibitor deficiency (C1-INH-HAE). Microtrauma can precipitate the onset of acute AE attacks, and thus, dental-oral procedures carry a high risk of triggering them and also an increased risk of death from asphyxiation due to the AE location. In the past, without proper specific treatment, the overall mortality after dental surgery in patients with C1-INH-HAE was up to 30-40%. Some dental-oral, medical and/or surgical procedures are susceptible to receive "short-term prophylaxis" (STP) in order to reduce the risk of AE. We describe the published case reports of dental-oral, maxillofacial and ear, nose and throat (ENT) procedures in patients with C1-INH-HAE. Different consensus algorithms and clinical guidelines have been published for managing dental-oral, maxillofacial and otolaryngological procedures (DOMFOPs) and will be reviewed below. Based on the clinical experience of the Department of Allergology of the University Hospital La Paz (Madrid) and the University General Hospital Nuestra Señora del Prado (Talavera de la Reina), these algorithms have been updated and modified. We advise to classify procedures according to the risk of producing AE as minor, intermediate and major risks.

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Uncommon Diseases in the ICU

Leone¹,

Martin²,

Vincent³

2014

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Risk of laryngeal edema and facial swellings after tooth extraction in patients with hereditary angioedema with and without prophylaxis with C1 inhibitor concentrate: a retrospective study

Cited by 125 publications

References 31 publications

Novelties in the Diagnosis and Treatment of Angioedema

Novelties in the Diagnosis and Treatment of Angioedema

Short‐Term Prophylaxis in Odontostomatological, Maxillofacial and ENT Procedures in Patients with Hereditary Angioedema Due to C1‐Inhibitor Deficiency

Uncommon Diseases in the ICU

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