Retrospective Evaluation of Patients with Angioedema Treated with C1 Inhibitors in an Emergency Department

Abstract

Aim:We aimed first to investigate patients who received C1 inhibitor therapy in the emergency department (ED). The patients’ complaints, examination findings, length of stay in the ED and whether the patients were treated with anything other than C1 inhibitor were investigated. Next, we examined the response of patients who received C1 inhibitor therapy in the presence of angiotensin converting enzyme inhibitor (ACEI)-induced angioedema.Materials and Methods:A retrospective descriptive study was designed. Patients who received C1 inhibitor therapy between January 2011 and February 2018 were reviewed using the hospital’s records on file.Results:Data were evaluated from 62 admissions for 23 different patients. The diagnosis of hereditary angioedema (HAE) was present in 65.2% (n=15) of the patients, and 85.5% (n=53) of the admissions were related to acute HAE episodes. The main complaints of these patients were nausea, vomiting and abdominal pain and swell of the face, lips, throat and extremities. It was determined that C1 inhibitor treatment was given to 8% (n=5) admissions due to ACEI-induced angioedema. The complaints of these patients (5 admissions for 4 patients) were swelling of the tongue (n=3), lip (n=1) and face (n=1). Clinical improvement was observed in admission symptoms after treatment of C1 inhibitor in all patients with angioedema induced by HAE episodes or ACEIs.Conclusion:C1 inhibitor treatment is effective in treating acute HAE episodes. Although more evidence is needed for the treatment of ACEI-induced angioedema attacks, C1 inhibitor therapy may be considered in patients who do not respond to classical treatment.

Keywords

• hereditary angioedema
• c1 inhibitor
• angiotensin-converting enzyme inhibitor
• histamine
• bradykinin
• emergency medicine