PMID- 36065111
OWN - NLM
STAT- MEDLINE
DCOM- 20220908
LR  - 20221212
IS  - 1539-6304 (Electronic)
IS  - 1088-5412 (Linking)
VI  - 43
IP  - 5
DP  - 2022 Sep 1
TI  - Longitudinal experience with treatment of acquired angioedema using tranexamic 
      acid.
PG  - 413-418
LID - 10.2500/aap.2022.43.220043 [doi]
AB  - Background: Acquired angioedema (AAE) is a rare form of angioedema (AE) and is 
      often associated with lymphoproliferative conditions and/or anti-C1 esterase 
      inhibitor (C1-INH) antibodies without clear treatment consensus. Current 
      treatments have been reported to have variable effectiveness with different 
      safety concerns. A large Italian cohort of patients with AAE was previously found 
      to respond well to tranexamic acid (TXA). Herein, we report our experience 
      treating AAE with TXA used as prophylaxis. Objective: The objective was to 
      describe clinical characteristics of patients with AAE and to report our 
      experience with treating AAE with TXA. Methods: A retrospective chart review of 
      patients with AAE (N = 13) from a large practice was conducted to assess 
      characteristics and treatment responses. Patient demographics in addition to 
      C1-INH quantitative, C1-INH functional, C4, and C1q levels; the presence of 
      C1-INH antibodies; and a history of lymphoproliferative disease were extracted. 
      The patients were also characterized by their treatment response to TXA. Results: 
      All the patients were white, with a mean age at diagnosis of 67 years, an average 
      body mass index of 31.3 kg/m(2), and a male-to-female ratio of 7:6. Nine patients 
      had positive C1-INH antibodies. The patients were on various prophylaxis 
      treatments before TXA, including chemotherapy that targeted malignancy, 
      cyclophosphamide, rituximab, and plasmapheresis. Ultimately, 11 of the 13 
      patients were on TXA for prophylaxis. At 1, 12, and 24 months after TXA 
      treatment, attacks decreased by 97, 86, and 99%, respectively. One patient 
      developed a deep vein thrombosis and TXA was stopped. Conclusion: These findings 
      demonstrated that treatment of AAE with TXA was effective as prophylaxis for AE 
      attacks. However, potential adverse effects remain a concern, which emphasizes 
      the need for additional options.
FAU - Kesh, Susamita
AU  - Kesh S
AD  - From the Division of Immunology and Allergy, Department of Pediatrics, Cincinnati 
      Children's Hospital Medical Center, Cincinnati, Ohio.
FAU - Singh, Umesh
AU  - Singh U
AD  - Division of Immunology/Allergy Section, Department of Internal Medicine, 
      University of Cincinnati College of Medicine, Cincinnati, Ohio; and.
FAU - Bernstein, Jonathan A
AU  - Bernstein JA
AD  - Division of Immunology/Allergy Section, Department of Internal Medicine, 
      University of Cincinnati College of Medicine, Cincinnati, Ohio; and.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Allergy Asthma Proc
JT  - Allergy and asthma proceedings
JID - 9603640
RN  - 0 (Complement C1 Inhibitor Protein)
RN  - 6T84R30KC1 (Tranexamic Acid)
RN  - Acquired angioedema
SB  - IM
MH  - *Angioedema/diagnosis
MH  - *Angioedemas, Hereditary/diagnosis
MH  - Complement C1 Inhibitor Protein/therapeutic use
MH  - Female
MH  - Humans
MH  - *Lymphoproliferative Disorders
MH  - Male
MH  - Retrospective Studies
MH  - *Tranexamic Acid/therapeutic use
EDAT- 2022/09/07 06:00
MHDA- 2022/09/09 06:00
CRDT- 2022/09/06 00:32
PHST- 2022/09/06 00:32 [entrez]
PHST- 2022/09/07 06:00 [pubmed]
PHST- 2022/09/09 06:00 [medline]
AID - 10.2500/aap.2022.43.220043 [doi]
PST - ppublish
SO  - Allergy Asthma Proc. 2022 Sep 1;43(5):413-418. doi: 10.2500/aap.2022.43.220043.