Hereditary angioedema: uncomplicated maxillofacial surgery using short-term C1 inhibitor replacement therapy.
We report on the successful use of a pasteurized C1 inhibitor (C1-INH) concentrate during dental surgery of a patient affected by hereditary angioedema. The patient recovered fully without complications or side effects. Within 30 min, the first 1,000 U of C1-INH concentrate raised C1-INH concentration from 19 to 55% and function from 40 to 90% of the normal mean. When measured 4 h after the second injection, a further increase of the C1-INH concentration to 86% and a function of 106% relative to the normal mean was observed. Within 2 weeks C1-INH concentration returned to pretreatment level, while the function remained above this value. Serum liver enzyme values did not change and no anti-C1-INH alloantibodies were detected 10 months post-replacement therapy. We conclude that in patients affected by C1-INH deficiency, dental surgery and likely other traumatic procedures can be safely performed in conjunction with C1-INH replacement therapy even without preliminary treatment.
Division of Immunology and Allergy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
A
A
Leimgruber
W A
WA
Jaques
P J
PJ
Spaeth
D000293:Adolescent; D000799:Angioedema / Q000276:immunology* / Q000601:surgery*; D003174:Complement C1 Inactivator Proteins / Q000172:deficiency / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008964:Molar, Third / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*
D003174:Complement C1 Inactivator Proteins