2016, Number 2
<< Back Next >>
Rev Cubana Hematol Inmunol Hemoter 2016; 32 (2)
Hereditary angioedema
Ustariz GCR
Language: Spanish
References: 51
Page: 176-189
PDF size: 135.99 Kb.
ABSTRACT
Hereditary angioedema is a rare disease with autosomal dominant inheritance that is
characterized by edema in skin and mucosa of various organs, mainly gastrointestinal
tract and the respiratory system. Clinical manifestations may be mild or severe,
depending on their location and intensity. The most severe forms are edema of the
glottis, and the edema of gastrointestinal tract which can cause severe dehydration
and abdominal pain that can be confused with an acute abdomen and unnecessary
surgery. The edema is characterized by not being itchy, no temperature rise, nonmarking
when pressed and usually have a family history. No predilection for sex, or
skin color. Its diagnosis is necessary to make a thorough examination and additional
tests of the complement system. They described two classic forms called HAE type I
and type II, type I is the most common. Recently it described the type III that occurs
only in females, without quantitative or qualitative alteration of C1 inhibitor and is
associated with the consumption of drugs or oral contraceptives containing estrogen.
The treatment is based primarily on the use of attenuated androgens or
antifibrinolytic and avoiding risk factors if they are known. In cases of acute
conditions present you can use fresh frozen plasma and purified C1 inhibitor
concentrate (Berinert-500) for intravenous use and rapid response; but the use of
subcutaneous epinephrine may not be very effective. Steroids and antihistamines
have no effectiveness when used in these patients.
REFERENCES
Iglesias Diez L, Guerra Tapia A; Ortiz Romero PL, Tratado de Dermatología. 2a Ed. Madrid:Mc Graw-Hill Interamericana de España; 2004.
Fitzpatrick T. Dermatología en Medicina General. 5ª. ed. Buenos Aires: Medica Panamericana. 2001.
Delves PJ. Angiodema. Merck Manual. Professional version. (Internet) Disponible en: http://www.merckmanuals.com/professional/SearchResults?query=Angioedema&icd9=99 5.1%3b277.6 [citado enero 25, 2015]
Cicardi M, Zanacheli A. Angiodema due to C1 inhibitor deficiency in 2010. Intern Emerg Med. 2010 Dec;5(6):481-6. doi: 10.1007/s11739-010-0408-3.
Ocampo Bustos F. Angiodema hereditario y adquirido. (Internet) Disponible en: http://www.medicosecuador.com/espanol/articulos_medicos/angioedemahereditario. htm . (citado enero 25, 2015)
Dobó J, Gál P, Szilágyi K, Cseh S, Lörincz Z, Schumaker VN, et al. One active C1r subunit is sufficient for the activity of the complement C1 complex: stabilization of C1r in the zymogen form by point mutations. J Immunol. 1999; 162 (2): 1108-12.
Ziccardi RJ. Spontaneous activation of the first component of human complement (C1) by an intramolecular autocatalytic mechanism. J Immunol. 1982; 128 (6):2500-4.
Bianchino AC, Poon PH, Schumaker VN. Amechanism for the spontaneous activation of the first component of complement, C1 and its regulation by C1 inhibitor. J Immunol. 1988; 141 (11): 3930-6.
Davis AE. C1 inhibitor and hereditary angioneuroticedema. Ann Rev Immunol. 1988; 6: 595-628.
Oltvai ZN, Wong ECC, Atkinson JP, Tung KSK. C1 inhibitor deficiency: molecular and immunological basis of hereditary and acquired angioedema. Lab Invest. 1991; 65 (4): 381-8.
Walport MJ. Complement. First of two parts. N Engl J Med. 2001; 344 (14):1058.
Zuraw BL, Lotz M. Regulation of the hepatic synthesis of C1 inhibitor by the hepatocyte stimulating factors interleukin 6 and interferon gamma. J Biol Chem.1990; 265 (21): 12664-70.
Falus A, Rokita H, Walcz E, Brozik M, Hidvegi T, Meretey K. Hormonal regulation of complement biosynthesis in human cell lines, II upregulation of the biosynthesis of complement components C3, factor B and C1 inhibitor by interleukin 1 in human hepatoma cell line. MolImmunol. 1990; 27 (2): 197-201.
Colman RW, Schmaier AH. Contact system: a vascular biology modulator with anticoagulant, profibrinolytic, antiadhesive and proinflamatory attributes. Blood. 1997; 90 (10): 3819-43.
Cumming SA, Halsall DJ, Ewan PW, Lomas DA. The effect of sequence variations within the coding region of the C1 inhibitor gene on disease expression and protein function in families with hereditary angioedema. J Med Genet. 2003 Oct;40(10):e114.
Bowen B, Hawk JJ, Sibunka S, Howick S, Weiler JM. A review of the reported defects in the human C1 esterase inhibitor gene producing hereditary angioedema including four new mutations. Clin Immunol. 2001; 98 (2): 157-63.
Davis AE, 3rd. The patho physiology of hereditary angioedema. Clin Immunol 2005;114(1):3-9.
Grigoriadou S, Longhurst HJ. Clinical Immunology Review Series: An approach to the patient with angioedema. Clin Exp Immunol. Mar 2009; 155 (3): 367-77.
Bork K, Barnsted S, Koch P, Traupe H. Hereditary angioedema with normal C1- inhibitor activity in women. Lancet 2000; 356 (9225): 213-7.
Gompels MM, Lock RJ, Morgan JE, Osborne J, Brown A, Virgo PF. A multicentre evaluation of the diagnostic efficiency of serological investigations for C1 inhibitor deficiency. J Clin Pathol. 2002; 55 (2): 145-7.
Ugochukwu C, Nzeako MD, Frigas E, Tremaine WJ. Hereditary Angioedema. A broad review for clinicians. Arch Intern Med. 2001; 161(20): 2417-29.
Borum ML, Howard DE. Hereditary angioedema: complex symptoms come make diagnosis difficult. Postgrad Med. 1998; 103 (4): 251-6.
Agostini A, Cicardi M. Hereditary and acquired C1-inhibitor deficiency: biological and clinical characteristics en 235 patients. Medicine (Baltimore). 1992; 71 (4): 206-15.
Shinzato T, Nakamura H, Kuniyoshi T, Higashionna A, Uehara T, Oshiro J, et al. Hereditary angioedema: a case with ascites yet not symptoms in the family. Intern Med. 1992; 31 (5): 633-5.
Sofia S, Casali A, Bolondi L. Sonografic finding in abdominal hereditary angioedema. J Clin Ultrasound. 1999; 27 (9): 537-40.
Bork K, Siedlecki K, Bosch S, Schopf R, Kreuz W. Asphyxation by laryngeal edema in patients with hereditary angioedema. Mayo Clin Proc. 2000; 75 (4): 349-54.
Frank MM, Gelfand JA, Atkinson JP. Hereditary angioedema: the clinical syndrome and its management. Ann Intern Med. 1976; 84 (5): 580-93.
Heymann WR. Acquired angioedema. J Am AcadDermatol. 1997; 36 (4): 611-5.
Ogston D, Walker J, Campbell DM. C1 inactivator level in pregnancy. Thromb Res. 1981; 23 (4-5); 453-5.
Cohen AJ, Laskin C, Tarlo S. C1 esterase inhibitor in pregnancy. J Allergy Clin Immunol. 1992; 90 (3Pt1): 412-3.
Wilson CL. Hereditary angioedema: a potential emergency. CRNA. 1996; 7 (2): 108-9.
Bork K, Ressel N. Suden upper airway obstruction in patients with hereditary angioedema. Transfus Apher Sci. 2003; 29 (3): 235-8.
Sunder TR, Balsam MJ, Vengrow MI. Neurological manifestations of angioedema: report of two cases and review of the literature. JAMA. 1982; 247 (14): 2005-7.
Neri S, Ierna D, Sfogliano L. Unusual manifestations of hereditary angioedema. Eur J Emergency Med. 2000; 7 (2): 111-2.
Van Dellen RG, Myers RP. Bladder involvement in hereditary angioedema. Mayo Clinic Proc. 1980; 55 (4): 277-8.
Donaldson VH, Hess EV, Mc Adams AJ. Lupus-erythematosus-like disease in the unrelated women with hereditary angioneurotic edema. Ann Intern Med. 1997; 86 (3: 312-3.
Pocheco TR, Weston WL, Giclas PC, Collier DH, Lee LA. Three generations of patients with lupus erythematosus and hereditary angioedema. Am J Med. 2000; 109 (3): 256-7.
Brickman CM, Tsokos GC, Balow JE. Immunoregulatory disorders associated with hereditary angioedema, I: Clinical manifestations of autoimmune disease. J Allergy Clin Immunol. 1986; 77 (5): 749-57.
Eck SL, Morse JH, Janssen DA, Emerson SG, Markowitz DM. Angioedema presenting as chronic gastrointestinal symptoms. Am J Gastroenterol. 1993; 88 (3): 436-9.
Talavera A, Larraona JL, Ramos JL, López T, Maraver A, Arias J, et al.Hereditary angioedema: an infrequent causa of abdominal pain with ascites. Am J Gastroenterol. 1995; 90 (3):471-4.
Laurent J, Guinnepain MT. Angioedema associated with C1 inhibitor deficiency. Clin Rev Allergy Immunol.1999; 17 (4): 513-23.
Bork K, Pitton M, Harten P, Koch P. Hepatocellular adenomas in patients takendanazol for hereditary angioedema. Lancet. 1999; 353 (9158): 1066-7.
Crampon D, Barnoud R, Durand M, Ponard D, Jacquot C, Sotto JJ, et al. Danazol therapy: an unusual aetiology of hepatocellular carcinoma. J Hepatol. 1998; 29 (6): 1035-6.
Jaffe CJ, Atkinson JP, Gelfand JA, Frank MM. Hereditary angioedema: the use of fresh frozen plasma for prophylaxis in patients undergoing oral surgery. J Allergy Clin Immunol. 1975; 55 (6): 386-93.
Frank MM. Urticaria and angioedema. In: Goldman L, Bennett JC, eds. Cecil Texbook of Medicine. 21st ed. Philadelphia: WB Saunders; 2000.p.1440-5.
Roth M, Schreier L, Cutier R. Adrenalin treatment for hereditary angioneurotic edema. Ann Allergy. 1975; 35 (3): 175-9.
Waytes AT, Rosen FS, Frank M. Treatment of hereditary angioedema with a vapor-heated C1 inhibitor concentrate. N Engl J Med. 1996; 334 (25): 1630-4.
Kreuz W, Martinez-Saguer I, Aygoren-PursunE,Rusicke E, Heller C, Klingebiel T. C1-inhibitor concentrate for individual replacement therapy in patients with severe hereditary angioedema refractory to danazol prophylaxis. Transfusion. 2009 Sep;49(9):1987-95. doi: 10.1111/j.1537-2995.2009.02230.x.
De Serres J, Groner A, Lindner J. Safety and efficacy of pasteurized C1 inhibitor concentrate (BerinertP) in hereditary angioedema: a review. Transfus Apher Sci. 2003; 29 (3): 247-54.
Weller K, Magerl M, Maurer M. Succesfull treatment of an acute attack of acquired angioedema with the bradykinin-B2-receptor antagonist icatibant. J Eur Acad Dermatol Venereol. 2011 Jan;25(1):119-20. doi: 10.1111/j.1468- 3083.2010.03712.x.
Zuraw B. HAE therapies: past, present and future. Allergy Asthma Clin Immunol. 2010 Jul 28;6(1):23. doi: 10.1186/1710-1492-6-23.