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Effectiveness of C1-INH therapy in angiotensin converting enzyme inhibitor induced angioedema
- Source :
- Allergy, Asthma & Clinical Immunology, Vol 17, Iss 1, Pp 1-4 (2021), Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology
- Publication Year :
- 2021
- Publisher :
- BMC, 2021.
-
Abstract
- Introduction Angiotensin Converting Enzyme Inhibitors (ACEI) are a common cause of Emergency Room presentation for angioedema. Although no treatment guidelines exist, C1 esterase inhibitor concentrate (C1-INH) is used on an off label basis for management of ACEI acquired angioedema (ACEI AAE). Objective To evaluate the efficacy of C1-INH in management of ACEI AAE at our local centers. Results Nine patients, from 3 academic sites, were identified through Allergy Service consultation data and records from Diagnostic Services Manitoba, Canada from 2010–2020. The majority of the patients (n = 8/9) required endotracheal intubation prior to the initiation of C1-INH. Overall, approximately 56% of patients (n = 5/9) had resolution of angioedema ranging between 12 and 17 h, with a median time of 13.5 h, and no recurrence after the administration of C1-INH concentrate. One patient had transient symptom resolution in 14 h, however, recurrence of angioedema required re-intubation. The remainder of patients (n = 4/9), had resolution of angioedema between 22 and 72 h, with a median time of 33.75 h. Conclusion Our findings demonstrate continued ambivalence of the efficacy and role of C1-INH concentrate in the treatment of ACEI AAE, secondary to multiple uncontrolled confounding factors. Further research into characterizing a subgroup of intubated patients in our study that responded to C1-INH concentrate needs to be completed.
- Subjects :
- lcsh:Immunologic diseases. Allergy
Allergy
medicine.medical_specialty
Acquired angioedema
Endotracheal intubation
030204 cardiovascular system & hematology
Off-label use
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
cardiovascular diseases
Letter to the Editor
Angioedema
biology
business.industry
Angiotensin-converting enzyme
General Medicine
medicine.disease
C1 esterase
030228 respiratory system
Median time
biology.protein
medicine.symptom
business
lcsh:RC581-607
Subjects
Details
- Language :
- English
- ISSN :
- 17101492
- Volume :
- 17
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Allergy, Asthma & Clinical Immunology
- Accession number :
- edsair.doi.dedup.....2344333ebf54741c039e44b2cbfdb79e