PMID- 22197274
OWN - NLM
STAT- MEDLINE
DCOM- 20120412
LR  - 20171116
IS  - 1097-6825 (Electronic)
IS  - 0091-6749 (Linking)
VI  - 129
IP  - 2
DP  - 2012 Feb
TI  - International consensus and practical guidelines on the gynecologic and obstetric 
      management of female patients with hereditary angioedema caused by C1 inhibitor 
      deficiency.
PG  - 308-20
LID - 10.1016/j.jaci.2011.11.025 [doi]
AB  - BACKGROUND: There are a limited number of publications on the management of 
      gynecologic/obstetric events in female patients with hereditary angioedema caused 
      by C1 inhibitor deficiency (HAE-C1-INH). OBJECTIVE: We sought to elaborate 
      guidelines for optimizing the management of gynecologic/obstetric events in 
      female patients with HAE-C1-INH. METHODS: A roundtable discussion took place at 
      the 6th C1 Inhibitor Deficiency Workshop (May 2009, Budapest, Hungary). A review 
      of related literature in English was performed. RESULTS: Contraception: Estrogens 
      should be avoided. Barrier methods, intrauterine devices, and progestins can be 
      used. Pregnancy: Attenuated androgens are contraindicated and should be 
      discontinued before attempting conception. Plasma-derived human C1 inhibitor 
      concentrate (pdhC1INH) is preferred for acute treatment, short-term prophylaxis, 
      or long-term prophylaxis. Tranexamic acid or virally inactivated fresh frozen 
      plasma can be used for long-term prophylaxis if human plasma-derived C1-INH is 
      not available. No safety data are available on icatibant, ecallantide, or 
      recombinant human C1-INH (rhC1INH). Parturition: Complications during vaginal 
      delivery are rare. Prophylaxis before labor and delivery might not be clinically 
      indicated, but pdhC1INH therapeutic doses (20 U/kg) should be available. 
      Nevertheless, each case should be treated based on HAE-C1-INH symptoms during 
      pregnancy and previous labors. pdhC1INH prophylaxis is advised before forceps or 
      vacuum extraction or cesarean section. Regional anesthesia is preferred to 
      endotracheal intubation. Breast cancer: Attenuated androgens should be avoided. 
      Antiestrogens can worsen angioedema symptoms. In these cases anastrozole might be 
      an alternative. Other issues addressed include special features of HAE-C1-INH 
      treatment in female patients, genetic counseling, infertility, abortion, 
      lactation, menopause treatment, and endometrial cancer. CONCLUSIONS: A consensus 
      for the management of female patients with HAE-C1-INH is presented.
CI  - Copyright (c) 2012 American Academy of Allergy, Asthma & Immunology. Published by 
      Mosby, Inc. All rights reserved.
FAU - Caballero, Teresa
AU  - Caballero T
AD  - Servicio de Alergia, Hospital La Paz Health Research Institute (IdiPaz), 
      Biomedical Research Network on Rare Diseases-U754 (CIBERER), Madrid, Spain. 
      mteresa.caballero@idipaz.es
FAU - Farkas, Henriette
AU  - Farkas H
FAU - Bouillet, Laurence
AU  - Bouillet L
FAU - Bowen, Tom
AU  - Bowen T
FAU - Gompel, Anne
AU  - Gompel A
FAU - Fagerberg, Christina
AU  - Fagerberg C
FAU - Bjokander, Janne
AU  - Bjokander J
FAU - Bork, Konrad
AU  - Bork K
FAU - Bygum, Anette
AU  - Bygum A
FAU - Cicardi, Marco
AU  - Cicardi M
FAU - de Carolis, Caterina
AU  - de Carolis C
FAU - Frank, Michael
AU  - Frank M
FAU - Gooi, Jimmy H C
AU  - Gooi JH
FAU - Longhurst, Hilary
AU  - Longhurst H
FAU - Martinez-Saguer, Inmaculada
AU  - Martinez-Saguer I
FAU - Nielsen, Erik Waage
AU  - Nielsen EW
FAU - Obtulowitz, Krystina
AU  - Obtulowitz K
FAU - Perricone, Roberto
AU  - Perricone R
FAU - Prior, Nieves
AU  - Prior N
CN  - C-1-INH Deficiency Working Group
LA  - eng
PT  - Consensus Development Conference
PT  - Journal Article
PT  - Practice Guideline
PT  - Research Support, Non-U.S. Gov't
DEP - 20111224
PL  - United States
TA  - J Allergy Clin Immunol
JT  - The Journal of allergy and clinical immunology
JID - 1275002
RN  - 0 (Complement C1 Inactivator Proteins)
RN  - 0 (Complement C1 Inhibitor Protein)
RN  - 0 (SERPING1 protein, human)
SB  - IM
MH  - Breast Neoplasms/complications
MH  - Chemoprevention
MH  - Complement C1 Inactivator Proteins/*deficiency
MH  - Complement C1 Inhibitor Protein
MH  - Contraception
MH  - Delivery, Obstetric
MH  - Female
MH  - Genetic Counseling
MH  - Genital Diseases, Female/complications
MH  - *Hereditary Angioedema Types I and II/complications/diagnosis/drug 
      therapy/genetics
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Lactation
MH  - Menopause
MH  - Menstruation
MH  - Pregnancy
MH  - *Pregnancy Complications, Cardiovascular/diagnosis/drug therapy
MH  - Prenatal Diagnosis
EDAT- 2011/12/27 06:00
MHDA- 2012/04/13 06:00
CRDT- 2011/12/27 06:00
PHST- 2011/06/10 00:00 [received]
PHST- 2011/10/27 00:00 [revised]
PHST- 2011/11/21 00:00 [accepted]
PHST- 2011/12/27 06:00 [entrez]
PHST- 2011/12/27 06:00 [pubmed]
PHST- 2012/04/13 06:00 [medline]
AID - S0091-6749(11)01830-6 [pii]
AID - 10.1016/j.jaci.2011.11.025 [doi]
PST - ppublish
SO  - J Allergy Clin Immunol. 2012 Feb;129(2):308-20. doi: 10.1016/j.jaci.2011.11.025. 
      Epub 2011 Dec 24.