Preoperative Approach to Hereditary Angioedema Patients in Two Cases

Year 2018, Volume: 20 Issue: 2, 221 - 225, 31.08.2018

Hülya Nazik , Perihan Öztürk , Mehmet Kamil Mülayim , İnci Dalyan

https://doi.org/10.24938/kutfd.341226

Abstract

Our aim is
to draw attention to the importance of prophylactic treatment in preoperative,
perioperative and postoperative period for hereditary angioedema patients for
whom minor or major surgery is planned. Two patients with a diagnosis of
hereditary angioedema were treated with 1000 IU C1 esterase inhibitor 1-6 hours
before minor surgery. Case 1 did not develop an attack during the procedure and
within postoperative one month. In case 2 with incomplete lupus erythematosus,
angioedema occurred in the lips one hour after the procedure. One more dose of
C1 esterase inhibitor was administered to the patient and angioedema was
delayed within half an hour. In this study, it was aimed to emphasize the
importance of prophylactic treatment to prevent attack development during the
procedure in patients with hereditary angioedema.

Keywords

Hereditary angioedema, prophylaxis, C1 esterase inhibitor

İKİ OLGU İLE HEREDİTER ANJİYOÖDEMLİ HASTALARA PREOPERATİF YAKLAŞIMIN GÖZDEN GEÇİRİLMESİ

Abstract

Küçük veya
büyük cerrahi işlem planlanan herediter anjiyoödem olguları için preoperatif
dönemde proflaktik tedavinin önemi, perioperatif ve postoperatif dönemde
karşılaşılabilecek sorunlar konusuna dikkat çekilmesi amaçlanmıştır. Herediter
anjiyoödem tanısı ile takibi süren 2 olguya minör cerrahi işlemden 1-6 saat
önce 1000 IU C1 esteraz inhibitörü uygulandı. Olgu 1'de işlem sırasında ve
sonraki bir ayda atak gelişmedi. İnkomplet lupus eritematozusu olan olgu 2’de
ise işlemden bir saat sonra dudakta anjiyoödem ortaya çıktı. Hastaya bir doz
daha C1 esteraz inhibitörü verildi ve anjiyoödem yarım saat içinde geriledi. Bu
çalışmada herediter anjiyoödemli hastalarda işlem sırasında atak gelişimine
engel olmak için proflaktik tedavinin önemine dikkat çekilmesi amaçlanmıştır.

Keywords

proflaksi, Herediter anjiyoödem, C1 esteraz inhibitörü

References

• 1. Bhardwaj N, Craig TJ. Treatment of hereditary angioedema: A review (CME). Transfusion. 2014;54(11):2989-96.
• 2. Cicardi M, Aberer W, Banerji A, Bas M, Bernstein JA, Bork K, et al. Classification, diagnosis, and approach to treatment for angioedema: Consensus report from the Hereditary Angioedema International Working Group. Allergy. 2014;69(5):602-16.
• 3. Craig T, Shapiro R, Vegh A, Baker JW, Bernstein JA, Busse P, et al. Efficacy and safety of an intravenous C1-inhibitor concentrate for long-term prophylaxis in hereditary angioedema. Allergy Rhinol (Providence). 2017;8(1):13-9.
• 4. Gurmen ES, Dogan S, Sert E, Dikmetas C, Hussein S. Effect of C1 esterase inhibitor in hereditary angioedema treatment. Am J Emerg Med. 2017;35(6):942.
• 5. Teranishi R, Makino Y, Amano E, Shibuya H, Okada T. Perioperative management of a patient with hereditary angioedema: a case report. Masui. 2015;64(4):441-3.
• 6. Steiner UC, Weber-Chrysochoou C, Helbling A, Scherer K, Grendelmeier PS, Wuillemin WA. Hereditary angioedema due to C1-inhibitor deficiency in Switzerland: clinical characteristics and therapeutic modalities within a cohort study. Orphanet J Rare Dis. 2016;11:43.
• 7. Sarici G, Koca R, Tekin NS, Altinyazar HC. A family with hereditary angioedema having been followed as familial mediterranean fever. Archives of the Turkish Dermatology and Venerology. 2009;43:29-31.
• 8. Henao MP, Kraschnewski JL, Kelbel T, Craig TJ. Diagnosis and screening of patients with hereditary angioedema in primary care. Ther Clin Risk Manag. 2016;12:701-11.
• 9. Kus S, Yucelten D. Hereditary Angioedema: Report of Three Cases and Approach to Diagnosis and Management. Turkish Journal of Dermatology. 2009;3:43-6.
• 10. Ekinci Z, Ozturk K. Systemic lupus erythematosus with C1q deficiency: treatment with fresh frozen plasma. Lupus. 2018;27(1):134-8.
• 11. Maynard AA, Burger CF, Schlesinger JJ. Angioedema: Perioperative management. Open Med Case Rep. 2017;5:1-4.
• 12. Greve J, Strassen U, Gorczyza M, Dominas N, Frahm UM, Mühlberg H et al. Prophylaxis in hereditary angioedema (HAE) with C1 inhibitor deficiency. J Dtsch Dermatol Ges. 2016;14:266-75.
• 13. Pathria M, Krishnaswamy G, Guarderas JC. Hereditary angioedema: Implications of management. South Med J. 2017;110(2):101-6.
• 14. Williams A, Craig T. Perioperative management of patients with hereditary angioedema. Allergy Rhinol. 2015;6:50-5.