설문조사를 통한 국내 유전성 혈관부종 진료 현황 및 국내 사례 문헌고찰
Clinical experience in managing patients with hereditary angioedema in Korea: questionnaire survey and a literature review
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Purpose: Hereditary angioedema is a familial disease which is caused by a genetic deficiency or functional defect of the C1 inhibitor, and it features episodic swelling that can affect any part of the body. A great number of patients are estimated not to have an accurate diagnosis after the onset of symptoms, and close attention is required because sudden hereditary angioedema attacks can result in even death. Methods: We sent an e-mail questionnaire to 975 members of the Korean Academy of Asthma, Allergy and Clinical Immunology. A total of 82 members replied. The questionnaire, including 15 questions about the diagnosis and management of hereditary angioedema, was developed by the anaphylaxis/urticaria, angioedema workgroup of the Korean Academy of Asthma, Allergy and Clinical Immunology. Results: Forty-two percent of the respondents had experience with treatment of a suspected case of hereditary angioedema, and 15.9% made a confirmed diagnosis of hereditary angioedema. When the respondents suspected of cases, 91.4% of them performed tests for C3 and C4 concentrations and C1 inhibitor level. For maintenance treatment, most of the respondents used androgen, and only 22% found that C1 inhibitor concentrates can be prescribed through the Korea Orphan Drug Center in Korea. Conclusion: Allergy physicians in Korea substantially recognized the correct diagnosis and treatment of hereditary angioedema. However, there was a lack of awareness for the latest treatments, such as C1 inhibitor concentrates. Education of doctors and the public is needed.
Abstract
Purpose: Hereditary angioedema is a familial disease which is caused by a genetic deficiency or functional defect of the C1 inhibitor, and it features episodic swelling that can affect any part of the body. A great number of patients are estimated not to have an accurate diagnosis after the onset of symptoms, and close attention is required because sudden hereditary angioedema attacks can result in even death. Methods: We sent an e-mail questionnaire to 975 members of the Korean Academy of Asthma, Allergy and Clinical Immunology. A total of 82 members replied. The questionnaire, including 15 questions about the diagnosis and management of hereditary angioedema, was developed by the anaphylaxis/urticaria, angioedema workgroup of the Korean Academy of Asthma, Allergy and Clinical Immunology. Results: Forty-two percent of the respondents had experience with treatment of a suspected case of hereditary angioedema, and 15.9% made a confirmed diagnosis of hereditary angioedema. When the respondents suspected of cases, 91.4% of them performed tests for C3 and C4 concentrations and C1 inhibitor level. For maintenance treatment, most of the respondents used androgen, and only 22% found that C1 inhibitor concentrates can be prescribed through the Korea Orphan Drug Center in Korea. Conclusion: Allergy physicians in Korea substantially recognized the correct diagnosis and treatment of hereditary angioedema. However, there was a lack of awareness for the latest treatments, such as C1 inhibitor concentrates. Education of doctors and the public is needed.
참고문헌 (32)
- Davis AE 3rd, "The pathophysiology of hereditary angioedema", Clin Immunol, 114, pp.3~9 (2005)
- Longhurst H, "Hereditary angio-oedema", Lancet, 379, pp.474~481 (2012)
- Bygum A, "Hereditary angio-oedema in Denmark: a nationwide survey", Br J Dermatol, 161, pp.1153~1158 (2009)
- Roche O, "Hereditary angioedema due to C1 inhibitor deficiency: patient registry and approach to the prevalence in Spain", Ann Allergy Asthma Immunol, 94, pp.498~503 (2005)
- Agostoni A, "Hereditary and acquired C1-inhibitor deficiency: biological and clinical characteristics in 235 patients", Medicine (Baltimore), 71, pp.206~215 (1992)
- Bork K, "Clinical studies of sudden upper airway obstruction in patients with hereditary angioedema due to C1 esterase inhibitor deficiency", Arch Intern Med, 163, pp.1229~1235 (2003)
- Gompels MM, "A multicentre evaluation of the diagnostic efficiency of serological investigations for C1 inhibitor deficiency", J Clin Pathol, 55, pp.145~147 (2002)
- Tosi M, "Molecular genetics of C1 inhibitor", Immunobiology, 199, pp.358~365 (1998)
- Warin RP, "Recurrent angioedema: familial and oestrogen-induced", Br J Dermatol, 115, pp.731~734 (1986)
- Vitrat-Hincky V, "Type III hereditary angio-oedema: clinical and biological features in a French cohort", Allergy, 65, pp.1331~1336 (2010)
- Bork K, "Hereditary angioedema caused by missense mutations in the factor XII gene: clinical features, trigger factors, and therapy", J Allergy Clin Immunol, 124, pp.129~134 (2009)
- Bork K, "A novel mutation in the coagulation factor 12 gene in subjects with hereditary angioedema and normal C1-inhibitor", Clin Immunol, 141, pp.31~35 (2011)
- Bygum A, "Acquired angioedema: occurrence, clinical features and associated disorders in a Danish nationwide patient cohort", Int Arch Allergy Immunol, 162, pp.149~155 (2013)
- Cicardi M, "Acquired angioedema", Allergy Asthma Clin Immunol, 6, pp.14~ (2010)
- Agostoni A, "Hereditary and acquired angioedema: problems and progress: proceedings of the third C1 esterase inhibitor deficiency workshop and beyond", J Allergy Clin Immunol, 114(3 Suppl), pp.S51~S131 (2004)
- Lee JH, "A case of hereditary angioedema", Allergy, 14, pp.695~701 (1994)
- Lee YS, "A case of hereditary angioedema", Korean J Dermatol, 32, pp.115~118 (1994)
- Suh KS, "Three cases of hereditary angioedema in one family", Korean J Dermatol, 33, pp.564~569 (1995)
- Lee JA, "A case of hereditary angioedema not manifestated classical autosomal dominant trait", Korean J Allergy, 17, pp.574~579 (1997)
- Kim SH, "A case of hereditary angioedema associated with idiopathic hypoparathyroidism", Korean J Intern Med, 16, pp.281~283 (2001)
- Kang HR, "Normal C1 inhibitor mRNA expression level in type I hereditary angioedema patients: newly found C1 inhibitor gene mutations", Allergy, 61, pp.260~264 (2006)
- 신미용, "A Case of Hereditary Angioedema in a 7-Year-Old Korean Girl", Allergy, Asthma & Immunology Research, 5(1), pp.59~61 (2013), 대한천식알레르기학회
- 이서영, "유전성 혈관부종 환자에서의 성공적인 제왕절개 분만 1예", 천식 및 알레르기, 32(4), pp.264~267 (2012), 대한천식알레르기학회
- Jung JW, "Clinical characteristics of hereditary angioedema patients in single tertiary hospital in Korea", Fall conference of the Korean Association of Internal Medicine, 1, pp.318~ (2011), Korean Association of Internal Medicine
- Wagenaar-Bos IG, "Functional C1-inhibitor diagnostics in hereditary angioedema: assay evaluation and recommendations", J Immunol Methods, 338, pp.14~20 (2008)
- Iwamoto K, "National prevalence survey of hereditary angioedema in Japan", Arerugi, 60, pp.26~32 (2011)
- Cicardi M, "Evidence-based recommendations for the therapeutic management of angioedema owing to hereditary C1 inhibitor deficiency: consensus report of an International Working Group", Allergy, 67, pp.147~157 (2012)
- Zuraw BL, "Nanofiltered C1 inhibitor concentrate for treatment of hereditary angioedema", N Engl J Med, 363, pp.513~522 (2010)
- Bork K, "Asphyxiation by laryngeal edema in patients with hereditary angioedema", Mayo Clin Proc, 75, pp.349~354 (2000)
- Zuraw BL, "Clinical practice. Hereditary angioedema", N Engl J Med, 359, pp.1027~1036 (2008)
- Lim YC, "Hereditary angioneurotic edema of the larynx", Acta Otolaryngol, 125, pp.1240~1243 (2005)
- 정진영, "Migraine-like Headache in a Patient with Complement 1 Inhibitor Deficient Hereditary Angioedema", Journal of Korean Medical Science, 27(1), pp.104~106 (2012), 대한의학회
