Sex hormones in hereditary angioneurotic oedema.
OBJECTIVE
The fluctuations in sex hormone levels at the beginning of adolescence, in the perimenopausal period, during pregnancy or during the use of oral contraceptives can precipitate oedematous attacks in hereditary angioneurotic oedema (HANO). Attacks usually disappear after the onset of menopause. This study was undertaken to establish any relationship between the serum levels of sex hormones and the incidence of HANO attacks.


METHODS
Serum levels of LH, FSH, progesterone, oestradiol, testosterone, PRL and SHBG were measured in 78 patients [mean age 30.3 years (range 4-70 years)] with HANO. A questionnaire was used to explore the medical history of adult patients to characterize the evolution and the characteristics of attacks.


RESULTS
The number of attacks was significantly higher [odds ratio (OR) 6.36 (1.31-30.81); P = 0.022] in females with high progesterone levels (> or = 4 nmol/l), irrespective of age, menstrual cycle and danazol dose. The OR was even higher [13.4 (2.2-81.4); P = 0.005] when only subcutaneous attacks were considered. Multiple logistic regression analysis demonstrated a significantly lower attack frequency during 1-year follow-up in patients with a higher (40 nmol/l) SHBG level (OR 0.25 (0.07-0.90); P = 0.034). This difference existed independently of age and danazol dose.


CONCLUSIONS
In view of these results, the monitoring of progesterone and SHBG levels can prove useful in the prediction of attacks in hereditary angioneurotic oedema.
Visy
B
B
Kútvölgyi Clinical Centre, Semmelweis University, Budapest, Hungary.
Füst
G
G
Varga
L
L
Szendei
G
G
Takács
E
E
Karádi
I
I
Fekete
B
B
Harmat
G
G
Farkas
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000799:Angioedema / Q000097:blood* / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003613:Danazol / Q000627:therapeutic use; D004958:Estradiol / Q000097:blood; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D016015:Logistic Models; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood
D015415:Biomarkers; D004965:Estrogen Antagonists; D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D003613:Danazol