Hereditary angioedema and its current management

Authors

  • Lay Salazar Torres Policlínico “Chiqui Gómez Lubián”, Santa Clara, Villa Clara, Cuba
  • Lázara Gladys López Ocampo Policlínico “Chiqui Gómez Lubián”, Santa Clara, Villa Clara, Cuba

Keywords:

angioedema, complement C1 inhibitor protein, laryngeal edema, abdomen, acute

Abstract

Hereditary angioedema is a primary immune deficiency of the complement system, of genetic origin, caused by alteration of the gene that encodes the inhibitor protein C1 esterase activated. It is characterized by recurrent episodes of angioedema of the skin, mucous and submucosal tissues and can affect any part of the body; typically it involves the extremities, face, airway and digestive tract. Abdominal pain associated with angioedema can be confused with an acute abdomen when there is no diagnosis of the disease and lead to unnecessary surgery. The laryngeal edema represents a risk to the life of the patient because it can cause death by suffocation. In women, the hormonal changes seem to have a strong impact on the disease, it is important that doctors know what to do when a patient is pregnant. Some professionals have ignorance of the disease and no access to treatment. Recently the therapeutic approach is directed to prevent the production of bradykinin or inhibit its function to block the function of its B2 receptor. At present, the drugs approved internationally for the effective treatment of this affection are Berinert P and Icatiban.

Downloads

Download data is not yet available.

Author Biographies

Lay Salazar Torres, Policlínico “Chiqui Gómez Lubián”, Santa Clara, Villa Clara, Cuba

Especialista de I y II Grado en Inmunología. Máster en Atención Integral al Niño. Diplomada en Nutrición Humana. Profesora Asistente de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Lázara Gladys López Ocampo, Policlínico “Chiqui Gómez Lubián”, Santa Clara, Villa Clara, Cuba

Especialista de I Grado Ginecología y Obstetricia. Profesora Asistente de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

References

1. Bousfiha AA, Jeddane L, Ailal F, Al Herz W, Conley ME, Cunningham-Rundles C, et al. A phenotypic approach for IUIS PID classification and diagnosis: guidelines for clinicians at the bedside. J Clin Immunol [Internet]. 2013 [citado 12 Abr 2015];33(6):1078-87. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23657403

2. Velasco Medina AA, Cortés Morales G, Barreto Sosa A, Velázquez-Sámano G. Fisiopatología y avances en el tratamiento del angioedema hereditario. Rev Alergia Mex [Internet]. 2011 [citado 12 Abr 2015];58(2):112-119. Disponible en: http://www.imbiomed.com.mx/1/1/articulos.php?method=showDetail&id_articulo=80627&id_seccion=66&id_ejemplar=7970&id_revista=12

3. Vives Toledo R, Sorlí Guerola JV, Sierra Santosa L, García Ribes M. Angioedema hereditario. Rev Clín Med Fam [Internet]. 2015 [citado 12 Abr 2015];8(1): 62-65. Disponible en: http://www.redalyc.org/pdf/1696/169639635008.pdf

4. Osorio HE, Rodríguez JA. Angioedema hereditario. Acta Med Colomb [Internet]. 2012 [citado 20 Jul 2014]; 37(1): 34-37. Disponible en: http://www.redalyc.org/pdf/1631/163124295007.pdf

5. Atkinson JP, Cicardi M, Zuraw B. Hereditary angioedema: pathogenesis and diagnosis. UptoDate [base de datos en Internet]. 2014 Oct 20. Disponible en: https://scholar.google.com.cu/scholar?hl=es&q=Atkinson+JP%2C+Cicardi+M%2C+Zuraw+B.+Hereditary+angioedema%3A+pathogenesis+and+diagnosis&btnG=&lr

6. Longhurst H, Cicardi M. Hereditary angio-oedema. Lancet [Internet]. 2012 [citado 12 Abr 2015];379(9814):474-481. Disponible en: http://www.sciencedirect.com/science/article/pii/S0140673611609355

7. Zanichelli A, Arcoleo F, Pina Barca M, Borelli P, Bova M, Cancian M, et al. A nationwide survey of hereditary angioedema due to C1 inhibitor deficiency in Italy. Orphanet J Rare Dis [Internet]. 2015 [citado 12 Abr 2016];10:11. Disponible en: https://ojrd.biomedcentral.com/articles/10.1186/s13023-015-0233-x

8. Farkas H, Csuka D, Gács J, Cazaller I, Zotter Z, Füst G, et al. Lack of increased prevalence of immunoregulatory disorders in hereditary angioedema due to C1-inhibitor deficiency. Clin Immunol [Internet]. 2011 [citado 12 Abr 2015]; 141(1):58-66. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21636327

9. Reshef A, Prematta MJ, Craig TJ. Signs and symptoms preceding acute attacks of hereditary angioedema: results of three recent surveys. Allergy Asthma Proc [Internet]. 2013 [citado 12 Abr 2015]; 34(3):261-6. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23676575

10. Ferrari Acosta MG, Amoroso Cosimini LE. Evaluación perioperatoria de una paciente con un angioedema grave para una cirugía de coordinación. Anest Analg Reanim [Internet]. 2013 [citado 12 Abr 2015];26(1):[aprox. 14 p.]. Disponible en: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-12732013000100008

11. Kusuma A, Relan A, Knulst AC, Moldovan D, Zuraw B, Cicardi M, et al. Clinical impact of peripheral attacks in hereditary angioedema patients. Am J Med [Internet]. 2012 [citado 12 Abr 2015];125(9):937.e17-24. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22748405

12. Bonnaud I, Rouaud V, Guyot M, Debiais S, Saudeau D, De Toffol B, et al. Exceptional stroke-like episodes in a patient with type I autosomal angioedema. Neurology [Internet]. 2012 [citado 12 Abr 2015];78(8):598-599. Disponible en: http://www.neurology.org/content/78/8/598.short

13. Kessel A, Peri R, Perricone R, Guarino MD, Vadasz Z, Novak R, et al. The autoreactivity of B cells in hereditary angioedema due to C1 inhibitor deficiency. Clin Exp Immunol [Internet]. 2012 [citado 12 Abr 2015];167(3):422-8. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374274/

14. Rodrigues Miranda A, Fusel de Ue AP, Vilarinho Sabbag DV, Furlani WJ, De Souza PK, et al. Angioedema hereditário tipo III (estrógeno-dependente): relato de três casos e revisão da literatura. An Bras Dermatol [Internet]. 2013 [citado 2 May 2016];88(4):[aprox. 11 p.]. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962013000400578

15. Craig T, Aygören-Pürsün E, Bork K, Bowen T, Boysen H, Farkas H, et al. WAO guideline for the management of hereditary angioedema. World Allergy Organ J [Internet]. 2012 [citado 2 May 2016];5(12):182-99. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23282420

16. Hemperly SE, Agarwal NS, Xu YY, Zhi YX, Craig TJ. Recent advances in the management of hereditary angioedema. J Am Osteopath Assoc [Internet]. 2013 [citado 12 Abr 2015];113(7):546-555. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23843378

17. Johnston DT, Lode H. Progress with management of hereditary angioedema. MMW Fortschr Med [Internet]. 2013 [citado 12 Abr 2015];155 (Supl1):1-5. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23678665

18. Navarro Ruiz A, Crespo Diz C, Poveda Andrés JL, Cebollero de Torre A. Algoritmo de diagnóstico y tratamiento del angioedema hereditario como herramienta para su manejo. Farm Hosp [Internet]. 2013 [citado 12 Abr 2015];37(6):521-529. Disponible en: http://scielo.isciii.es/pdf/fh/v37n6/12articuloespecial02.pdf

19. Johnston DT. Diagnosis and management of hereditary angioedema. J Am Osteopath Assoc [Internet]. 2011 [citado 12 Nov 2016];111(1):28-36. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21258014

20. Delves PJ. Hereditary and acquired angioedema. Manual Merck [Internet]. 2016 [citado 12 Abr 2016]. Disponible en: http://www.merckmanuals.com/professional/immunology-allergic-disorders/allergic,-autoimmune,-and-other-hypersensitivity-disorders/hereditary-and-acquired-angioedema

21. Bernstein JA, Moellman J. Emerging concepts in the diagnosis and treatment of patients with undifferentiated angioedema. Int J Emerg Med [Internet]. 2012 [citado 12 Abr 2015];5(1):39. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23131076

22. Dreskin SC. Urticaria and angioedema. En: Goldman L, Schafer AI, editores. Goldman's Cecil medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2012.

23. Parish LC. Hereditary angioedema: diagnosis and management-a perspective for the dermatologist. J Am Acad Dermatol [Internet]. 2011 [citado 12 Abr 2015];65(4):843-850. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21550133

24. Pérez Alonso AJ, Del Olmo Rivas C, Ruiz García VM, Pérez Ramón JA, Jiménez Ríos JA. Angioedema hereditario: causa rara de dolor abdominal. Cir Esp [Internet]. 2012 [citado 12 Abr 2015];90(4):[aprox. 3 p.]. Disponible en: http://www.elsevier.es/es-revista-cirugia-espanola-36-articulo-angioedema-hereditario-causa-rara-dolor-S0009739X11001540?redirectNew=true

25. Salas-Lozano NG, Meza-Cardona J, González-Fernández C, Pineda-Figueroa L, De Ariño-Suárez M. Angioedema hereditario: causa rara de dolor abdominal. Cir Cir [Internet]. 2014 [citado 12 Abr 2015];82(5):563-566. Disponible en: http://www.redalyc.org/pdf/662/66231760013.pdf

26. Nzeako UC, Longhurst HJ. Many faces of angioedema: focus on the diagnosis and management of abdominal manifestations of hereditary angioedema. Eur J Gastroenterol Hepatol [Internet]. 2012 [citado 12 Abr 2015];24(4):353-61. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22410711

27. Ohsawa I, Nagamachi S, Suzuki H, Honda D, Sato N, Ohi H, et al. Leukocytosis and high hematocrit levels during abdominal attacks of hereditary angioedema. BMC Gastroenterol [Internet]. 2013 [citado 12 Abr 2015];13:123. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23915279

28. Bork K, Hardt J, Witzke G. Fatal laryngeal attacks and mortality in hereditary angioedema due to C1-INH deficiency. J Allergy Clin Immunol [Internet]. 2012 [citado 19 Mar 2015];130(3):692-7. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22841766

29. Caballero T, Farkas H, Bouillet L, Bowen T, Gompel A, Fagerberg C. International consensus and practical guidelines on the gynecologic and obstetric management of female patients with hereditary angioedema caused by C1 inhibitor deficiency. J Allergy Clin Immunol [Internet]. 2012 [citado 29 Sept 2015];129(2):308-320. Disponible en: http://www.jacionline.org/article/S0091-6749%2811%2901830-6/pdf

30. Di Marco PM. Angioedema hereditario [tesis]. [Internet]. Argentina: Universidad de Buenos Aires. Facultad de Medicina; 2012 [citado 20 Abr 2016]. Disponible en: http://www.aaiba.org.ar/links/Monografias_Angioedema_DiMarco.pdf

31. Malbrán A, Fernández Romero DS, Menéndez A. Angioedema hereditario. Guía de tratamiento. Medicina (B. Aires) [Internet]. 2012 [citado 29 Sept 2015];72(2): [aprox. 9 p.]. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S0025-76802012000200006

32. Cicardi M, Bork K, Caballero T, Craig T, Li HH, Longhurst H, et al. Evidence-based recommendations for the therapeutic management of angioedema owing to hereditary C1- inhibitor deficiency: consensus report of an International Working Group. Allergy [Internet]. 2012 [citado 12 Abr 2015];67(2): 147-57. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22126399

33. Cicardi M, Craig TJ, Martinez-Saguer I, Hébert J, Longhurst HJ. Review of recent guidelines and consensus statements on hereditary angioedema therapy with focus on self-administration. Int Arch Allergy Immunol [Internet]. 2013 [citado 12 Abr 2015];161(Supl 1):3-9. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23689238

34. Zuraw BL, Banerji A, Bemstein JA, Busse PJ, Christiansen SC, Davis-Lorton M, et al. US Hereditary Angioedema Association Medical Advisory Board 2013 recommendations for the management of hereditary angioedema due to C1 inhibitor deficiency. J Allergy Clin Imunol Pract [Internet]. 2013 [citado 2 Sept Abr 2015];1(5):458-67. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/24565617

35. Malbrán A, Malbrán E, Menéndez A, Fernández Romero DS. Angioedema hereditario. Tratamiento del ataque agudo en la Argentina. Medicina (B. Aires) [Internet]. 2014 [citado 2 Sept Abr 2015];74(3):[aprox. 5 p.]. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S0025-76802014000300003

36. Riedl MA. Creating a comprehensive treatment plan for hereditary angioedema. Immunol Allergy Clin North Am [Internet]. 2013 [citado 12 Abr 2015];33(4):471-85. Disponible en: www.ncbi.nlm.nih.gov/pubmed/24176212

37. Bernstein JA, Moellman JJ. Progress in the emergency management of hereditary angioedema: focus on new treatment options in the United States. Postgrad Med [Internet]. 2012 [citado 12 Abr 2015];124(3):91-100. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22691903

38. Riedl MA, Bernstein JA, Li H, Reshef A, Lumry W, Moldovan D, et al. Recombinant human C1-esterase inhibitor relieves symptoms of hereditary angioedema attacks: phase 3, randomized, placebo-controlled trial. Ann Allergy Asthma Immunol [Internet]. 2014 [citado 12 Abr 2016];112(2):163-169. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/24468257

39. Prematta MJ, Bewtra AK, Levy RJ, Wasserman RL, Jacobson KW, Machnig T, et al. Per-attack reporting of prodromal symptoms concurrent with C1-inhibitor treatment of hereditary angioedema attacks. Adv Ther [Internet]. 2012 [citado 12 Abr 2015];29(10):913-22. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23054691

40. Lumry WR, Li HH, Levy RJ, Potter PC, Farkas H, Reshef A, et al. Results from FAST-3: A phase III randomized, double-blind, placebo-controlled, multicenter study of subcutaneous icatibant in patients with acute hereditary angioedema (HAE) attacks. J Allergy Clin Immunol [Internet]. 2011 [citado 2 Sept Abr 2015];127(2):[aprox. 2 p.]. Disponible en: http://www.jacionline.org/article/S0091-6749%2811%2900040-6/pdf

41. Lumry WR, Bernstein JA, Li HH, Macginnitie AJ, Riedl M, Soteres DF, et al. Efficacy and safety of ecallantide in treatment of recurrent attacks of hereditary angioedema: open-label continuation study. Allergy Asthma Proc [Internet]. 2013 [citado 16 Ene 2016];34(2):155-61. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23484891

42. Lumry WR, Li HH, Levy RJ, Potter PC, Farkas H, Moldovan D, et al. Randomized placebo-controlled trial of the bradykinin B2 receptor antagonist icatibant for the treatment of acute attacks of hereditary angioedema: the FAST-3 trial. Ann Allergy Asthma Immunol [Internet]. 2011 [citado 12 Abr 2015];107(6):529-37. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/22123383

43. Riedl M, Longhurst H, Fabien V, Lumry WR, Maurer M. Icatibant for the treatment of non-laryngeal hereditary angioedema attacks: comparison of outcomes from a controlled phase III trial and a real-world setting. Ann Allergy Asthma Immunol. 2013;111(5):48.

44. Maurer M, Aberer W, Bouillet L, Caballero T, Fabien V, Kanny G, et al. Hereditary angioedema attacks resolve faster and are shorter after early icatibant treatment. PLoS ONE [Internet]. 2013 [citado 29 Nov 2015]; 8(2): e53773. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/23390491

Published

2016-10-03

How to Cite

1.
Salazar Torres L, López Ocampo LG. Hereditary angioedema and its current management. Acta Méd Centro [Internet]. 2016 Oct. 3 [cited 2025 Jul. 5];10(4):91-103. Available from: https://revactamedicacentro.sld.cu/index.php/amc/article/view/770

Issue

Section

Review Articles