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Background Hereditary angioedema (HAE) is an autosomal dominant disorder characterized by recurrent episodes of angioedema without urticaria or pruritus. In this study, we compared the levels of anabolic hormones, such as insulin, insulin-like growth factor, growth hormone, and thyroid hormones (thyroid-stimulating hormone [TSH], triiodothyronine [T3], and thyroxine [T4]), and the levels of hormones that are considered catabolic, such as adrenocorticotrophic hormone (ACTH) and cortisol, between HAE patients and controls. We also discussed the contribution of these hormones to the pathophysiology of HAE. Material and Methods The study included 18 patients (9 diagnosed with HAE type 1 and 9 with HAE type 2) who were followed in the immunology and allergy clinic between January 2013 and January 2020. The control group comprised 28 age- and gender-matched healthy control subjects. For determination of hormone levels enzyme standard radioimmunoassay, immunometric and immunoluminometric assays were used. Results The HAE type 1, HAE type 2, and healthy control groups showed no significant differences in insulin, insulin-like growth factor, ACTH, cortisol, TSH, or T4 levels. The C-peptide and T3 levels were significantly different between the groups (p=0.011 and p=0.027, respectively). Post-hoc pairwise comparison revealed no significant difference in C-peptide level among the groups, but a significant difference in the T3 level was detected between HAE type 1 patients and controls (p=0.029). Conclusions Although no significant differences were observed in other anabolic hormone levels between the controls and HAE patients, T3 levels were significantly lower in type 1 HAE patients. Close monitoring of low T3 levels is required, particularly in patients with type 1 HAE. [ABSTRACT FROM AUTHOR]

Hereditary angioedema (HAE) is an autosomal dominant disorder. Considerable rate of mortality determines the importance of disease. In this paper, a patient with HAE who developed severe facial angioedema after the first dose of an antidepressant (Escitalopram) prescribed by a psychiatrist because of diagnosis of depression, was presented and discussed. In the presented case, severe facial angioedema was not found to be clearly associated with a particular cause. There were possibilities such as sporadic/idiopathic attack or depression related attack. However, occurrence of an acute attack soon after a newly started drug had to draw attention to Escitalopram. So, in patients with HAE under an antidepressant treatment, antidepressant related angioedema must be kept in mind when the HAE control deteriorated. [ABSTRACT FROM AUTHOR]

Background: Hereditary angioedema (HAE) is a rare, potentially life-threatening disease characterized by recurrent angioedema attacks. Abdominal symptoms of HAE typically mimic numerous abdominal emergencies, which may result in a delay of correct diagnosis and inappropriate treatments. Objective: We aimed to evaluate the difficulties experienced by patients with HAE in Turkish emergency departments (ED). Methods: We conducted face-to-face interviews with patients with HAE by using a questionnaire regarding the clinical and demographic data of the patients and difficulties encountered during ED admissions. Results: The mean (standard deviation) age of 34 patients with HAE (25 women, 9 men) was 36.2 ± 11.5 years and the mean (standard deviation) delay in diagnosis was 17.2 ± 9.7 years. Inappropriate treatment for HAE attacks was administered to 88.2% (n = 30) of patients in the ED, despite their diagnosis of HAE. The most frequent difficulty was 'not knowing how to administer C1 inhibitor concentrate' (n = 11 [32.4%]). Other difficulties encountered were as follows: ED staff being unaware of HAE (n = 6 [17.6%]), lack of C1 inhibitor concentrate in the ED (n = 3 [8.8%]), and kept waiting for the appropriate treatment in triage despite their having angioedema in the head-and-neck region (n = 2 [5.9%]). Conclusion: Patients with HAE encounter difficulties in the ED, and the delay in diagnosis could be due to a low level of awareness regarding HAE. Therefore, the management of HAE in EDs requires improvement. [ABSTRACT FROM AUTHOR]

Background: There is a clear association between autoimmune thyroiditis (AT) and chronic urticaria/angioedema (CUA). However, not all patients with AT demonstrate urticaria. Aims: The aim of the study was to investigate in which patients with AT did CUA become a problem. A sensitive inflammation marker, neopterine (NP) was used to confirm whether the severity of inflammation in the thyroid gland was responsible for urticaria or not. Methods: Neopterine levels were assessed in patients with AT with urticaria and without urticaria. Furthermore, levels were compared in relation to pre and post levothyroxine treatment. Twenty-seven patients with urticaria (Group 1) and 28 patients without urticaria (Group 2) were enrolled in the study. A course of levothyroxine treatment was given to all patients, and urine neopterine levels before and after the trial were obtained. Results: All patients completed the trial. Mean age in Group 1 and Group 2 was similar (35.70 ± 10.86 years and 38.36 ± 10.38 years, respectively) (P=0.358). Pre-treatment urine neopterine levels were significantly higher in Group 1 (P=0.012). Post-treatment levels decreased in each group, as expected. However, the decrease in the neopterine level was insignificant in the patients of Group 2 (P=0.282). In Group 1, a significant decrease in post-treatment neopterine levels (P=0.015) was associated with the remission of urticaria. Conclusion: In patients with CUA and AT, pre-treatment elevated levels of NP, and its decrease with levothyroxine treatment along with symptomatic relief in urticaria, may be evidence of the relationship between the degree of inflammation in thyroid and presence of urticaria. [ABSTRACT FROM AUTHOR]