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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12001/24891

Title :Perioperative management of a patient with hereditary angioedema with prophylactic administration of C1 esterase inhibitor
Authors :Kato, Tomoki
Sunagawa, Nao
Higa, Masaru
Authors affiliation :Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of the Ryukyus
Department of Oral and Maxillofacial Surgery, University of the Ryukyus Hospital
Department of Oral and Maxillofacial Surgery, Chubu Tokushukai Hospital
Issue Date :2020
Publisher :琉球医学会
Type Local :雑誌掲載論文
Type (NII) :Journal Article
ISSN :1346-888X
Abstract :Hereditary angioedema (HAE) is a rare autosomal dominant genetic disorder that causes a deficiency in or dysfunction of C1 esterase inhibitor (C1-INH). HAE attacks are caused by trauma, drugs, infection, or mental stress. Dental procedures in patients with HAE can trigger fatal laryngeal edema. We herein report a female patient with HAE who required tooth extraction. A 58-year-old Japanese woman was referred to our hospital for dental caries. Maxillary teeth contained residual roots that could not be preserved, and mandibular teeth had poor plaque control and progressive periodontal disease. Therefore, consent was obtained from the patient to create dentures after extraction of all remaining teeth. The patient had recurrent edema since she was approximately 20 years old. She was diagnosed with HAE due to C1-INH deficiency at our hospital. She had an HAE attack of the tongue and laryngeal edema and underwent emergency tracheotomy. Subsequently, she had repeated edema of the tongue and lips several times a month. She had edema following tooth extraction. She was referred to our hospital and her condition improved by intravenous administration of C1-INH. C1-INH and tranexamic acid were prophylactically administered 1 h preoperatively. Anesthesia was induced with intermittent infusion of midazolam and continuous infusion of dexmedetomidine. Local anesthesia was provided using 3% propitocaine with felypressin. The patient was transferred to the intensive care unit for further observation. There was no postoperative complication. She was discharged after 3 days. No other HAE complications occurred during the perioperative period, and perioperative management went well.
Rights :琉球医学会
URI :http://hdl.handle.net/20.500.12001/24891
Citation :琉球医学会誌 = Ryukyu Medical Journal Vol.39 no.1-4 p.45 -48
Appears in Collections:Ryukyu Medical Journal

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