Dental Procedures for Hereditary Angioedema Patients: What Happens in Real Life?

Öz

Objective Dental procedures are known to be potential trigger for attacks in hereditary angioedema (HAE). Therefore, we aimed to demonstrate the potential of dental procedures to trigger HAE attacks through real-life experiences. Method The files of 57 patients diagnosed with HAE type I-II and followed up at the Immunology Allergy Diseases Outpatient Clinic between January 1, 2018, and April 4, 2025, were examined. Results The study included 44 patients, and prophylaxis was administered to 27.3%, 26.7%, and 8.3% of those who underwent tooth extraction, filling, and root canal treatment, respectively. The frequency of attacks after tooth extraction was reduced in patients who received prophylaxis compared to those who did not receive prophylaxis, but this reduction was statistically insignificant (33.3% in those who did not receive prophylaxis vs. 22.2% in those who did). When comparing patients who experienced attacks without prophylaxis after tooth extraction with those who did not receive prophylaxis, it was observed that the group experiencing attacks was predominantly female (p=0.079). Attacks occurring after tooth extraction were not statistically significantly associated with attack triggers. Conclusion Most HAE patients do not receive prophylaxis before dental procedures. Given the risk of fatal laryngeal attacks, it is important to carefully assess patients for their prophylaxis needs before dental procedures, and to raise awareness among both patients and dentists regarding the risk of attacks despite prophylaxis.

Anahtar Kelimeler

• Hereditary angioedema
• prophylaxis
• atack
• real-world data

Herediter Anjiyoödem Hastalarında Dental Prosedürler: Gerçek Yaşamda Neler Oluyor?

Öz

Amaç Dental prosedürlerin herediter anjiyoödem (HAÖ) ataklarını tetikleyebilecek potansiyel faktör olduğu bilinmektedir. Bu nedenle, gerçek yaşam deneyimleri aracılığıyla diş işlemlerinin HAE ataklarını tetikleme potansiyelini göstermeyi amaçladık. Yöntem İmmünoloji Alerji Hastalıkları Polikliniğinde 1 Ocak 2018 ile 4 Nisan 2025 tarihleri arasında takip edilen ve HAE tip I-II tanısı konmuş 57 hastanın dosyaları incelendi. Bulgular Çalışmaya 44 hasta dahil edildi. Diş çekimi yapılanların %27,3’üne, dolgu yapılanların %26,7’sine ve kök kanal tedavisi geçirenlerin ise %8,3'üne profilaksi uygulanmıştı. Diş çekiminden sonra atak sıklığı, profilaksi almayanlara kıyasla profilaksi alan hastalarda azalmıştı ancak bu azalma istatistiksel olarak anlamlı değildi (%33,3 profilaksi almayanlarda, %22,2 profilaksi alanlarda). Diş çekiminden sonra profilaksi uygulanmadan atak geçiren hastalar ile profilaksi uygulanmayan hastalar karşılaştırıldığında, atak geçiren grubun çoğunlukla kadınlardan oluştuğu gözlemlenmiştir (p=0.079). Diş çekiminden sonraki ataklar ile atak tetikleyicileri arasında istatistiksel olarak anlamlı bir ilişki gözlenmemiştir. Sonuç Herediter anjioödem hastalarının çoğu diş işlemlerinden önce profilaksi almamaktadır. Ölümcül laringeal atak riski göz önüne alındığında, diş işlemlerinden önce hastaların profilaksi ihtiyaçlarının dikkatlice değerlendirilmesi ve hem hastalar hem de diş hekimleri arasında profilaksiye rağmen atak riski konusunda farkındalığın artırılması önemlidir.

Anahtar Kelimeler

• Herediter anjiyoödem
• profilaksi
• atak
• gerçek dünya verileri

Kaynakça

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