Management of oral surgery in patients with hereditary or acquired angioedemas: review and case report.
Angioedemas are a rare but significant event in simple oral surgery because they can cause an acute life-threatening laryngeal edema. We report a case of a tooth extraction in a patient with hereditary angioedema, for which the C1-inhibitor (C1-INH) concentration administered effectively controlled edema during and after extraction. We also review case reports of oral surgery management in patients with hereditary and acquired angioedemas. In 2 of 36 cases, laryngeal edema occurred after teeth extraction. One was considered to be a type 2 acquired angioedema, which tolerates replacement therapy with fresh frozen plasma. The other case was managed only with danazol, and it was suggested that this was on occasion insufficient. Safety of oral surgery on patients with angioedema depends on the type of angioedema and the availability of C1-INH concentration. An exact diagnosis of the type of angioedema is needed to know the effect of replacement therapy with C1-INH.
Okayama Univerity Dental Hospital, Okayama, Japan. maedas@md.okayama-u.ac.jp
Shigeru
S
Maeda
Takuya
T
Miyawaki
Shinsuke
S
Nomura
Toshiyuki
T
Yagi
Masahiko
M
Shimada
D000799:Angioedema / Q000150:complications / Q000235:genetics* / Q000517:prevention & control; D003174:Complement C1 Inactivator Proteins; D050718:Complement C1 Inhibitor Protein; D017742:Dental Care for Chronically Ill; D005260:Female; D006801:Humans; D007819:Laryngeal Edema / Q000517:prevention & control; D008875:Middle Aged; D015843:Serpins / Q000627:therapeutic use; D014081:Tooth Extraction
D003174:Complement C1 Inactivator Proteins; D050718:Complement C1 Inhibitor Protein; C469952:SERPING1 protein, human; D015843:Serpins