Asunto(s)
Antiinflamatorios no Esteroideos , Dipirona , Hipersensibilidad a las Drogas , Hipersensibilidad Tardía , Ibuprofeno , Humanos , Antiinflamatorios no Esteroideos/efectos adversos , Dipirona/efectos adversos , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad Tardía/diagnóstico , Ibuprofeno/efectos adversos , Activación de LinfocitosRESUMEN
BACKGROUND: Hereditary angioedema due to C1-esterase inhibitor deficiency (HAE-C1-INH) is a life-threatening disease. OBJECTIVES: To describe the clinical characteristics and management of patients with HAE-C1-INH during routine clinical practice. METHODS: An observational, retrospective study was performed in patients with HAE-C1-INH. Demographic, clinical, and analytical data were collected from 2 periods: period A (October 2009-September 2010) and period B (October 2007-September 2009). RESULTS: We studied 112 patients with HAE-C1-INH (57.1% females). Age at onset of symptoms was 14.4 years (lower in patients who had experienced attacks in the previous year). In period B (n=87), 62.1% of patients presented at least 1 edema attack (median, 3.5 attacks/patient/2 years), and 19.1% of attacks were treated. In period A (n=77), 58.4% of patients were on maintenance therapy. Stanozolol was the most widely used drug (48.9%), with a mean weekly dose of 6.7 mg. At least 1 attack was recorded in 72.7% of patients (median, 3.0 attacks/patient/year), and 31.5% of the attacks were treated. Treatment of acute attacks increased by 12.4%. CONCLUSION: Age at onset of symptoms is associated with clinical expression of disease. The higher age at onset of symptoms, the fewer number of attacks per patient and year, and the lower dose of attenuated androgens necessary to control the disease than in other series lead us to hypothesize that HAE-C1-INH could have a less severe expression in Spain. Acute attacks seem to be treated increasingly often.
Asunto(s)
Andrógenos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Antifibrinolíticos/uso terapéutico , Bradiquinina/análogos & derivados , Proteína Inhibidora del Complemento C1/uso terapéutico , Angioedema Hereditario Tipos I y II/tratamiento farmacológico , Adolescente , Adulto , Anciano , Bradiquinina/uso terapéutico , Niño , Preescolar , Manejo de la Enfermedad , Femenino , Angioedema Hereditario Tipos I y II/etiología , Angioedema Hereditario Tipos I y II/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenAsunto(s)
Vacuna contra Difteria, Tétanos y Tos Ferina/efectos adversos , Erupciones por Medicamentos/etiología , Vacunas contra Haemophilus/efectos adversos , Vacunas contra Hepatitis B/efectos adversos , Inmunización Secundaria/efectos adversos , Vacuna Antipolio de Virus Inactivados/efectos adversos , Factores de Edad , Reacción de Arthus , Celulitis (Flemón)/diagnóstico por imagen , Preescolar , Erupciones por Medicamentos/patología , Erupciones por Medicamentos/terapia , Humanos , Esquemas de Inmunización , Lactante , Masculino , Pruebas del Parche/efectos adversos , Vacunas Combinadas/efectos adversosAsunto(s)
Desensibilización Inmunológica , Tumor del Seno Endodérmico/terapia , Filgrastim/efectos adversos , Fármacos Hematológicos/efectos adversos , Neoplasias Vaginales/terapia , Neutropenia Febril Inducida por Quimioterapia/etiología , Neutropenia Febril Inducida por Quimioterapia/prevención & control , Preescolar , Tumor del Seno Endodérmico/complicaciones , Tumor del Seno Endodérmico/diagnóstico , Tumor del Seno Endodérmico/inmunología , Femenino , Filgrastim/administración & dosificación , Filgrastim/inmunología , Fármacos Hematológicos/administración & dosificación , Fármacos Hematológicos/inmunología , Humanos , Resultado del Tratamiento , Neoplasias Vaginales/complicaciones , Neoplasias Vaginales/diagnóstico , Neoplasias Vaginales/inmunologíaRESUMEN
BACKGROUND: Relatively few studies have examined the incidence of anaphylaxis in the general population. OBJECTIVE: To report the incidence of anaphylaxis among the general population of the city of Alcorcon, Spain, using various public health care databases. METHODS: Episodes of anaphylaxis were recovered using validated alphanumeric strings in different fields of electronic clinical records used in the different public health settings in the city of Alcorcon (primary care, Emergency Department, hospitalized patients and Allergy Outpatient Clinic). Patients with anaphylaxis were tracked across the different clinical settings in Alcorcon. RESULTS: The incidence of anaphylaxis in Alcorcon was 103.37 episodes per 100 000 person-years (total standardized incidence rate of 112.2). There was a peak of 313.58 episodes in the 0-4 years age group and a different distribution of incidence rates (although non-significant) among different age groups between male patients and female patients. In most age groups, incidence tended to be higher for female patients aged over 10 years. Patients were attended at two or more levels in 76.78% of episodes, and a new evaluation was often made at a primary care centre (71.43%), Allergy Outpatient Clinic (75.6%), or both after the episode (58.93%). CONCLUSION AND CLINICAL RELEVANCE: This study revealed a higher rate of anaphylaxis than that in previous studies, although this incidence rate is probably lower than the real incidence rate. Studies exploring potential methodological, genetic and environmental factors accounting for these higher rates of anaphylaxis are required.
Asunto(s)
Anafilaxia/epidemiología , Anafilaxia/etiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Salud Pública , España/epidemiología , Adulto JovenRESUMEN
BACKGROUND: There are no Spanish guidelines or consensus statement on bradykinin-induced angioedema. AIM: To review the pathophysiology, genetics, and clinical symptoms of the different types of bradykinin-induced angioedema and to draft a consensus statement in light of currently available scientific evidence and the experience of experts. This statement will serve as a guideline to health professionals. METHODS: The consensus was led by the Spanish Study Group on Bradykinin-Induced Angioedema (SGBA), a working group of the Spanish Society of Allergology and Clinical Immunology. A review was conducted of scientific papers on different types of bradykinin-induced angioedema (hereditary and acquired angioedema due to C1 inhibitor deficiency, hereditary angioedema related to estrogens, angioedema induced by angiotensin-converting enzyme inhibitors). Several discussion meetings of the SGBA were held in Madrid to reach the consensus. RESULTS: The pathophysiology, genetics, and clinical symptoms of the different types of angioedema are reviewed. Diagnostic approaches are discussed and the consensus reached is described. CONCLUSIONS: A review of bradykinin-induced angioedema and a consensus on diagnosis are presented.
Asunto(s)
Angioedema , Bradiquinina/efectos adversos , Vasoespasmo Coronario/tratamiento farmacológico , Hipersensibilidad a las Drogas/fisiopatología , Vasodilatadores/efectos adversos , Angioedema/clasificación , Bradiquinina/uso terapéutico , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad a las Drogas/epidemiología , Hipersensibilidad a las Drogas/genética , Servicios Médicos de Urgencia , Medicina Basada en la Evidencia , Testimonio de Experto , Humanos , Guías de Práctica Clínica como Asunto , Factores de Riesgo , España , Vasodilatadores/uso terapéuticoRESUMEN
BACKGROUND: There are no previous Spanish guidelines or consensus statements on bradykinin-induced angioedema. AIM: To draft a consensus statement on the management and treatment of angioedema mediated by bradykinin in light of currently available scientific evidence and the experience of experts. This statement will serve as a guideline to health professionals. METHODS: The consensus was led by the Spanish Study Group on Bradykinin-Induced Angioedema, a working group of the Spanish Society of Allergology and Clinical Immunology. A review was conducted of scientific papers on different types of bradykinin-induced angioedema (hereditary and acquired angioedema due to C1 inhibitor deficiency, hereditary angioedema related to estrogens, angioedema induced by angiotensin-converting enzyme inhibitors). Several discussion meetings were held to reach the consensus. RESULTS: Treatment approaches are discussed, and the consensus reached is described. Specific situations are addressed, namely, pregnancy, contraception, travelling, blood donation, and organ transplantation. CONCLUSIONS: A review of and consensus on treatment of bradykinin-induced angioedema is presented.
Asunto(s)
Angioedema , Bradiquinina/antagonistas & inhibidores , Angioedema/diagnóstico , Angioedema/metabolismo , Angioedema/terapia , Bradiquinina/metabolismo , Humanos , PronósticoRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Preescolar , Desensibilización Inmunológica , Tumor del Seno Endodérmico/terapia , Filgrastim/efectos adversos , Fármacos Hematológicos/efectos adversos , Neoplasias Vaginales/terapia , Neutropenia Febril Inducida por Quimioterapia/etiología , Neutropenia Febril Inducida por Quimioterapia/prevención & control , Filgrastim/administración & dosificación , Filgrastim/inmunología , Fármacos Hematológicos/administración & dosificación , Fármacos Hematológicos/inmunología , Resultado del Tratamiento , Neoplasias Vaginales/inmunología , Tumor del Seno Endodérmico/inmunologíaAsunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad Tardía/diagnóstico , Ibuprofeno/efectos adversos , Antiinflamatorios no Esteroideos/efectos adversos , Dipirona/efectos adversos , Activación de Linfocitos , Estudios Transversales , Estudios Retrospectivos , Curva ROCRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Preescolar , Vacunas Combinadas/efectos adversos , Erupciones por Medicamentos/etiología , Eritema Indurado/inducido químicamente , Vacuna Antipolio de Virus Inactivados/efectos adversos , Vacuna contra Difteria, Tétanos y Tos Ferina/efectos adversos , Vacunas contra Hepatitis B/efectos adversos , Vacunas contra Haemophilus/efectos adversos , Pruebas del Parche , Pruebas IntradérmicasRESUMEN
Background: Hereditary angioedema due to C1-esterase inhibitor deficiency (HAE-C1-INH) is a life-threatening disease. Objectives: To describe the clinical characteristics and management of patients with HAE-C1-INH during routine clinical practice. Methods: An observational, retrospective study was performed in patients with HAE-C1-INH. Demographic, clinical, and analytical data were collected from 2 periods: period A (October 2009-September 2010) and period B (October 2007-September 2009). Results: We studied 112 patients with HAE-C1-INH (57.1% females). Age at onset of symptoms was 14.4 years (lower in patients who had experienced attacks in the previous year). In period B (n=87), 62.1% of patients presented at least 1 edema attack (median, 3.5 attacks/patient/2 years), and 19.1% of attacks were treated. In period A (n=77), 58.4% of patients were on maintenance therapy. Stanozolol was the most widely used drug (48.9%), with a mean weekly dose of 6.7 mg. At least 1 attack was recorded in 72.7% of patients (median, 3.0 attacks/patient/year), and 31.5% of the attacks were treated. Treatment of acute attacks increased by 12.4%. Conclusion: Age at onset of symptoms is associated with clinical expression of disease. The higher age at onset of symptoms, the fewer number of attacks per patient and year, and the lower dose of attenuated androgens necessary to control the disease than in other series lead us to hypothesize that HAE-C1-INH could have a less severe expression in Spain. Acute attacks seem to be treated increasingly often (AU)
Antecedentes: El angioedema hereditario por déficit del inhibidor de la C1 esterasa (AEH-C1-INH) es potencialmente mortal. Objetivos: Describir las características clínicas y el manejo de pacientes con AEH-C1-INH durante la práctica clínica habitual. Métodos: Estudio retrospectivo observacional de pacientes con AEH-C1-INH. Se recogieron datos demográficos, clínicos y analíticos en los periodos A (Octubre 2009-Septiembre 2010) y B (Octubre 2007-Septiembre 2009). Resultados: Se estudiaron 112 pacientes con AEH-C1-INH (57,1% mujeres) con edad de inicio de los síntomas de 14,4 años (inferior en aquellos pacientes con ataques en el último año). En el periodo B (n=87) 62,1% tuvo al menos un ataque (mediana: 3,5 ataques/paciente /2 años) y el 19,9% de los ataques se trataron. En el periodo A (n=77) 58,4% recibieron tratamiento de mantenimiento, siendo el estanozolol el fármaco más utilizado (48,9%) (dosis media semanal 6,7mg). El 72,7% de los pacientes tuvo al menos un ataque (mediana: 3,0 ataques / paciente / año), el 31,5% se trataron. Hubo un incremento del 12,4% de tratamientos de ataques agudos. Conclusiones: La edad de inicio de los síntomas está relacionada con la expresión clínica de la enfermedad. La edad superior del inicio de los síntomas, el menor número de ataques por paciente/año, y una dosis inferior de andrógenos atenuados para controlar la enfermedad, comparado con otros países, permite hipotetizar que el AEH-C1-INH en España tendría una expresión clínica menos grave. Existe una tendencia al alza en la frecuencia de tratamiento de ataques agudos (AU)