title: Perioperative management of tooth extractions for a patient with hereditary angioedema.
abstract: Hereditary angioedema (HAE) is a rare genetic disorder that causes a deficiency in or dysfunction of C1 esterase inhibitor (C1-INH) and is clinically characterized by sudden and recurrent attacks of angioedema. Although almost any part of the body can be affected, HAE is of greatest concern and can be life-threatening when the upper airway is involved, particularly the larynx (laryngeal attack). HAE attacks can be triggered by physical or psychological stress or can arise spontaneously without any apparent trigger. Dental treatments and routine oral surgical procedures, such as tooth extraction, abound with factors that can trigger an attack of HAE. Indeed, several cases of death resulting from HAE attacks have been reported after such procedures. Therefore, patients with HAE are of special concern in dentistry and require precautionary preparations before treatment. This report describes the successful management of tooth extractions in a patient with HAE who was at high risk of an HAE-induced laryngeal attack.
authors.affiliation: Associate Professor, Department of Clinical Physiology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. Electronic address: sanuki@nagasaki-u.ac.jp.
authors.forename: Takuro
authors.initials: T
authors.lastname: Sanuki
authors.affiliation: Staff anesthesiologist, Department of Dental Anesthesiology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Assistant Professor, Department of Dental Anesthesiology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kurata
authors.affiliation: Chief Professor, Department of Clinical Physiology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Ayuse
mesh_terms: D000328:Adult; D054179:Angioedemas, Hereditary / Q000601:surgery*; D005260:Female; D006801:Humans; D019990:Perioperative Care; D014081:Tooth Extraction