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Title: | Acquired Angioedema due to C1-Inhibitor Deficiency: A Challenging Condition |
Authors: | VALLE, Solange Oliveira Rodrigues; ALONSO, Maria Luiza Oliva; DORTAS JR., Sergio Duarte; GOUDOURIS, Ekaterini Simoes; CARVALHO, Ana Luiza Ribeiro Bard de; CAPELO, Albertina Varandas; MANSOUR, Eli; BERNARDES, Ana Flavia; LEITE, Luiz Fernando Bacarini; GIAVINA-BIANCHI, Pedro; AUN, Marcelo Vivolo; FERRIANI, Mariana Paes Leme; ARRUDA, Luisa Karla; GRUMACH, Anete Sevciovic |
Citation: | INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY, v.183, n.5, p.572-577, 2022 |
Abstract: | Background: Acquired deficiency of C1 inhibitor (AAE-C1-INH) is a very rare cause of recurrent angioedema, with few cases reported in the literature. We aimed to describe a series of patients with AAE-C1-INH who were diagnosed and received care at angioedema reference centers in Brazil, affiliated to the Brazilian Group of Studies on Hereditary Angioedema. Methods: Fourteen patients from 8 Brazilian Angioedema Reference Centers, diagnosed with AAE-C1-INH, were included in this study. Clinical data collected included sex, date of birth, date of onset of symptoms, date of diagnosis, plasma levels of antigenic and/or functional C1-INH, levels of C4 and C1q, location and treatment of angioedema attacks, long-term prophylaxis, associated diseases, and definitive treatment. Results: Fourteen patients were identified with AAE-C1-INH. Most patients (10/14; 71.4%) were female. The median age at onset of symptoms was 56.5 years (range, 14-74 years; interquartile range [IQR], 32-64 years), and median age at diagnosis was 58.0 years (range, 20-76 years; IQR, 38-65 years), with a median time until diagnosis of 2 years (range, 0-6 years; IQR, 1-3 years). The most common manifestations were cutaneous (face, eyelids, lips, trunk, hands, feet, and genitals). Most patient had low levels of C4 (13/14; 92.8%) and of antigenic C1-INH (8/14; 57.1%). Four had decreased functional activity of C1-INH (4/7; 57.1%) and C1q levels were low in 5 patients (5/12; 41.6%). Underlying diseases were identified in all 14 patients, with lymphoma of the splenic marginal zone and monoclonal gammopathy of undetermined significance being the most frequent. Nine patients (64.2%) needed long-term prophylactic treatment for recurrent angioedema and 5 patients (46.7%) required treatment for angioedema attacks. Most of them (12/14; 85.7%) had resolution of angioedema. Conclusion: Therapy of AAE-C1-INH aims to control symptoms; however, diagnosis and treatment of the underlying disease, when present, should be an important target and may lead to the resolution of angioedema in patients with AAE-C1-INH. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCM Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - LIM/60 Artigos e Materiais de Revistas Científicas - ODS/03 |
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