Short-term prophylaxis in patients with angioedema due to C1-inhibitor deficiency undergoing dental procedures: An observational study

Autor: Girolamo Donati, Andrea Zanichelli, Alberto Busa, Romualdo Vacchini, Mario Ghezzi, Antonella Sparaco, Vito Rania, Ivan Santicchia, Marco Cicardi
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Larynx
Male
Teeth
Dental and Oral Procedures
Cancer Treatment
Disease
Pathology and Laboratory Medicine
0302 clinical medicine
Oral Diseases
Outpatients
Medicine and Health Sciences
Outpatient clinic
Child
Aged
80 and over
Multidisciplinary
Middle Aged
medicine.anatomical_structure
Treatment Outcome
Italy
Oncology
Medicine
Female
medicine.symptom
Anatomy
Complement C1 Inhibitor Protein
medicine.drug
Research Article
Adult
medicine.medical_specialty
Adolescent
Patients
Science
Oral Medicine
Surgical and Invasive Medical Procedures
03 medical and health sciences
Young Adult
Signs and Symptoms
Diagnostic Medicine
Internal medicine
medicine
Humans
Angioedema
Pathological
Aged
Danazol
business.industry
Angioedemas
Hereditary
Dental Prophylaxis
Biology and Life Sciences
030206 dentistry
Health Care
Abscesses
stomatognathic diseases
030228 respiratory system
Jaw
Dentistry
Observational study
business
Oral medicine
Digestive System
Head
Zdroj: PLoS ONE, Vol 15, Iss 3, p e0230128 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: Background Patients affected by angioedema due to hereditary and acquired C1-inhibitor (C1-INH) deficiency (HAE and AAE, respectively) report trouble accessing dental care, due to the risk of a life-threatening oropharyngeal and laryngeal attack triggered by dental procedures. The aim of this study was to assess the identification of hurdles in receiving dental care, and the effectiveness of short-term prophylaxis (STP) in preventing angioedema attacks. In addition, the study evaluated the impact of dental care in angioedema disease. All patients affected by angioedema due to C1-INH deficiency who were treated in the dentistry outpatient department of ASST Fatebenefratelli Sacco hospital (Milan, Italy) between 2009 and 2017 were considered for the analysis. Data were collected from patients’ records. Results Twenty-nine patients were analyzed (27 with HAE and 2 with AAE). Of these, 63.0% reported that they had previously experienced hurdles in accessing dental care. Among patients with pathological oral status, at the first visit, 59.26% patients had moderate-to-severe oral disease. Seventy-five dental procedures were performed in 20 patients. Sixty procedures were preceded by STP (58 with plasma-derived C1-INH and 2 with danazol) in patients with/without long-term prophylaxis (LTP). Post-procedural attacks occurred in two patients. One HAE patient undergoing a tooth extraction without STP/LTP experienced a laryngeal attack. The other post-procedural attack occurred in an AAE patient with anti-C1-INH antibodies with STP with pdC1-INH. The angioedema disease did not worsen in any patient after dental care, but improved in four of them. Conclusions Most C1-INH-HAE patients reported hurdles in receiving dental care. STP protects against attacks after dental procedures. Treating oral diseases results in improvement in the frequency of attacks.
Databáze: OpenAIRE
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