A case of hereditary angioedema (type III) in which mandibular wisdom tooth extraction was performed under intravenous sedation management without prophylactic administration of C1–INH

Abstract

We report a clinical case of a patient with hereditary angioedema (HAE, Type III) in which, by implementing careful preoperative preparations to prevent the occurrence of edema, good course was achieved without the prophylactic administration of C1-inhibitor (C1–INH). We recommended the prophylactic administration of Berinert P, a human plasma-derived C1–INH formulation; however, due to the risk of developing a viral infection, both the patient and her mother refused to receive Berinert P. In cases where C1–INH cannot be administered as a prophylactic measure, it is essential to make sufficient preparations, including urgent tracheotomy, to prevent sudden occurrence of edema, with the cooperation of the anesthesiologist.

Keywords

• Hereditary angioedema
• C1–INH
• Berinert P
• Tracheotomy