1
|
Maurer M, Magerl M, Ansotegui I, Aygören-Pürsün E, Betschel S, Bork K, Bowen T, Boysen HB, Farkas H, Grumach AS, Hide M, Katelaris C, Lockey R, Longhurst H, Lumry WR, Martinez-Saguer I, Moldovan D, Nast A, Pawankar R, Potter P, Riedl M, Ritchie B, Rosenwasser L, Sánchez-Borges M, Zhi Y, Zuraw B, Craig T. [Not Available]. ARERUGI = [ALLERGY] 2023; 72:158-183. [PMID: 36928049 DOI: 10.15036/arerugi.72.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Affiliation(s)
- M Maurer
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin
| | - M Magerl
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin
| | - I Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia
| | - E Aygören-Pürsün
- Center for Children and Adolescents, University Hospital Frankfurt
| | - S Betschel
- Division of Clinical Immunology and Allergy, St. Michael's Hospital, University of Toronto
| | - K Bork
- Department of Dermatology, Johannes Gutenberg University Mainz
| | - T Bowen
- Department of Medicine and Pediatrics, University of Calgary
| | | | - H Farkas
- Hungarian Angioedema Center, 3rd Department of Internal Medicine, Semmelweis University
| | - A S Grumach
- Clinical Immunology, Faculdade de Medicina ABC
| | - M Hide
- Department of Dermatology, Hiroshima University
| | - C Katelaris
- Department of Medicine, Campbelltown Hospital and Western Sydney University
| | - R Lockey
- Department of Internal Medicine, University of South Florida Morsani College of Medicine
| | - H Longhurst
- Department of Clinical Biochemistry and Immunology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust
| | - W R Lumry
- Department of Internal Medicine, Allergy/Immunology Division, Southwestern Medical School, University of Texas
| | | | | | - A Nast
- Berlin Institute of Health, Department of Dermatology, Venereology und Allergy, Division of Evidence based Medicine (dEBM), Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charité-Universitätsmedizin Berlin
| | - R Pawankar
- Department of Pediatrics, Nippon Medical School
| | - P Potter
- Department of Medicine, University of Cape Town
| | - M Riedl
- Department of Medicine, University of California-San Diego
| | - B Ritchie
- Division of Hematology, University of Alberta
| | - L Rosenwasser
- Allergy and Immunology Department, University of Missouri at Kansas City School of Medicine
| | - M Sánchez-Borges
- Allergy and Clinical Immunology Department, Centro Medico Docente La Trinidad
| | - Y Zhi
- Department of Allergy, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences
| | - B Zuraw
- Department of Medicine, University of California-San Diego
- San Diego VA Healthcare
| | - T Craig
- Department of Medicine and Pediatrics, Penn State University
| |
Collapse
|
2
|
Maurer M, Magerl M, Betschel S, Aberer W, Ansotegui IJ, Aygören-Pürsün E, Banerji A, Bara NA, Boccon-Gibod I, Bork K, Bouillet L, Boysen HB, Brodszki N, Busse PJ, Bygum A, Caballero T, Cancian M, Castaldo A, Cohn DM, Csuka D, Farkas H, Gompels M, Gower R, Grumach AS, Guidos-Fogelbach G, Hide M, Kang HR, Kaplan AP, Katelaris C, Kiani-Alikhan S, Lei WT, Lockey R, Longhurst H, Lumry WR, MacGinnitie A, Malbran A, Saguer IM, Matta JJ, Nast A, Nguyen D, Nieto-Martinez SA, Pawankar R, Peter J, Porebski G, Prior N, Reshef A, Riedl M, Ritchie B, Sheikh FR, Smith WB, Spaeth PJ, Stobiecki M, Toubi E, Varga LA, Weller K, Zanichelli A, Zhi Y, Zuraw B, Craig T. [Not Available]. ARERUGI = [ALLERGY] 2023; 72:237-272. [PMID: 37225467 DOI: 10.15036/arerugi.72.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Affiliation(s)
- M Maurer
- Institute of Allergology, Charité-Universitätsmedizin, Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology
| | - M Magerl
- Institute of Allergology, Charité-Universitätsmedizin, Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology
| | | | - W Aberer
- Department of Dermatology, Medical University of Graz
| | - I J Ansotegui
- Department of Allergy & Immunology, Hospital Quironsalud Bizkaia
| | - E Aygören-Pürsün
- Center for Children and Adolescents, University Hospital Frankfurt
| | - A Banerji
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital
| | - N A Bara
- Romanian Hereditary Angioedema Expertise Centre, Mediquest Clinical Research Center
| | - I Boccon-Gibod
- National Reference Center for Angioedema (CREAK), Angioedema Center of Reference and Excellence (ACARE), Grenoble Alpes University Hospital
| | - K Bork
- Department of Dermatology, University Medical Center, Johannes Gutenberg University
| | - L Bouillet
- National Reference Center for Angioedema (CREAK), Angioedema Center of Reference and Excellence (ACARE), Grenoble Alpes University Hospital
| | | | - N Brodszki
- Department of Pediatric Immunology, Childrens Hospital, Skåne University Hospital
| | - P J Busse
- Icahn School of Medicine at Mount Sinai
| | - A Bygum
- Clinical Institute, University of Southern Denmark
- Department of Clinical Genetics, Odense University Hospital
| | - T Caballero
- Allergy Department, Hospital Universitario La Paz
| | - M Cancian
- Department of Systems Medicine, University Hospital of Padua
| | | | - D M Cohn
- Department of Vascular Medicine, Amsterdam UMC/University of Amsterdam
| | - D Csuka
- Department of Internal Medicine and Haematology, Hungarian Angioedema Center of Reference and Excellence, Semmelweis University
| | - H Farkas
- Department of Internal Medicine and Haematology, Hungarian Angioedema Center of Reference and Excellence, Semmelweis University
| | - M Gompels
- Clinical Immunology, North Bristol NHS Trust
| | - R Gower
- Marycliff Clinical Research, Principle Research Solutions
| | - A S Grumach
- Clinical Immunology, Centro Universitario FMABC
| | | | - M Hide
- Department of Dermatology, Hiroshima Citizens Hospital
- Department of Dermatology, Hiroshima University
| | - H R Kang
- Department of Internal Medicine, Seoul National University College of Medicine
| | - A P Kaplan
- Division of Pulmonary, Critical Care, Allergy and Immunology, Medical University of South Carolina
| | - C Katelaris
- Department of Medicine, Campbelltown Hospital and Western Sydney University
| | | | - W T Lei
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Mackay Memorial Hospital
| | - R Lockey
- Division of Allergy and Immunology, Department of Internal Medicine, Morsani College of Medicine, University of South Florida
| | - H Longhurst
- Department of Immunology, Auckland District Health Board and Department of Medicine, University of Auckland
| | - W R Lumry
- Internal Medicine, Allergy Division, University of Texas Health Science Center
| | - A MacGinnitie
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School
| | - A Malbran
- Unidad de Alergia, Asma e Inmunología Clínica
| | - I M Saguer
- Pediatrics, Haemophilia Centre Rhine Main (HZRM)
| | - J J Matta
- H. Especialidades C.M.N.SXXI, I.M.S.S
| | - A Nast
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine Charité-Universitätsmedizin Berlin, corporate member of Free University of Berlin, Humboldt University of Berlin, and Berlin Institute of Health
| | - D Nguyen
- Respiratory, Allergy and Clinical Immunology Unit, Internal Medicine Department, Vinmec Healthcare System, College of Health Sciences, VinUniversity
| | | | - R Pawankar
- Department of Pediatrics, Nippon Medical School
| | - J Peter
- Division of Allergy and Clinical Immunology, University of Cape Town
- Allergy and Immunology Unit, University of Cape Town Lung Institute
| | - G Porebski
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College
| | - N Prior
- Allergy, Hospital Universitario Severo Ochoa
| | - A Reshef
- Angioderma Center, Barzilai University Medical Center
| | - M Riedl
- Division of Rheumatology, Allergy and Immunology, University of California San Diego
| | - B Ritchie
- Departments of Medicine and Medical Oncology, University of Alberta
| | - F R Sheikh
- Section of Adult Allergy & Immunology, Department of Medicine, King Faisal Specialist Hospital & Research Centre
| | - W B Smith
- Clinical Immunology and Allergy, Royal Adelaide Hospital
| | - P J Spaeth
- Institute of Pharmacology, University of Bern
| | - M Stobiecki
- Department of Clinical and Environmental Allergology, Jagiellonian University Medical College
| | - E Toubi
- Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Affiliated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology
| | - L A Varga
- Department of Internal Medicine and Haematology, Hungarian Angioedema Center of Reference and Excellence, Semmelweis University
| | - K Weller
- Institute of Allergology, Charité-Universitätsmedizin, Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology
| | - A Zanichelli
- Department of Internal Medicine, ASST Fatebenefratelli Sacco, Ospedale Luigi Sacco-University of Milan
| | - Y Zhi
- Department of Allergy and Clinical Immunology, Bejing Union Medical College Hospital & Chinese Academy of Medical Sciences
| | - B Zuraw
- University of California, San Diego
| | - T Craig
- Departments of Medicine and Pediatrics, Penn State University
| |
Collapse
|
3
|
Andarawewa S, Aygören-Pürsün E. Individual approach to long-term therapy in patients with hereditary angioedema (HAE-C1-INH): A case series. Front Allergy 2022; 3:949387. [PMID: 36032509 PMCID: PMC9411966 DOI: 10.3389/falgy.2022.949387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/19/2022] [Indexed: 12/05/2022] Open
|
4
|
Bouillet L, Maurer M, Reshef A, Kiani S, Wu A, Stobiecki M, Kinaciyan T, Peter J, Aygören-Pürsün E, Best J, Cornpropst M, Nagy E, Murray S, Collis P, Launay D, Farkas H. Sécurité et efficacité à long terme du bérotralstat (BCX7353) pour la prophylaxie des crises d’angiœdème héréditaire (AOH) : résultats de l’étude APeX-S. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
5
|
Maurer M, Bork K, Martinez-Saguer I, Aygören-Pürsün E, Botha J, Andresen I, Magerl M. Management of patients with hereditary angioedema in Germany: comparison with other countries in the Icatibant Outcome Survey. J Eur Acad Dermatol Venereol 2018; 33:163-169. [PMID: 30176179 PMCID: PMC6587717 DOI: 10.1111/jdv.15232] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 08/20/2018] [Indexed: 11/28/2022]
Abstract
Background The Icatibant Outcome Survey (IOS; NCT01034969) is a Shire‐sponsored, international, observational study monitoring the safety and effectiveness of icatibant, a bradykinin B2 receptor antagonist approved for the acute treatment of adults with hereditary angioedema with C1 inhibitor deficiency (HAE‐C1‐INH). Objective To report IOS data comparing demographic and icatibant treatment outcomes in patients with HAE‐C1‐INH from Germany to HAE‐C1‐INH patients from 11 other IOS countries. Methods A descriptive, retrospective, comparative analysis of data from 685 IOS patients with HAE‐C1‐INH from seven centres in Germany (n = 93) vs. centres from Austria, Brazil, Czech Republic, Denmark, France, Greece, Israel, Italy, Spain, Sweden and the United Kingdom (n = 592, July 2009–January 2017). Icatibant treatment outcomes were retrieved from patients with complete attack outcome data for time to treatment, time to resolution and attack duration (160 attacks in 42 German patients and 1442 attacks in 251 patients from other IOS countries). Results German patients reported significantly fewer severe/very severe attacks (38.7% vs. 57.5%, respectively; P < 0.001). The proportion of attacks treated with a single icatibant injection was significantly higher in German patients (97.1% vs. 91.6%, P = 0.0003). The median time to treatment (0.0 h vs. 1.5 h), time to resolution (3.0 h vs. 7.0 h) and attack duration (4.3 h vs. 10.5 h) in German patients vs. other IOS countries were all significantly shorter (all P < 0.0001). No meaningful differences were identified between patients from Germany and other countries with regard to sex, median age at enrolment, median age at symptom onset and median age at diagnosis. Conclusion German IOS patients share similar demographic characteristics to patients from other IOS countries yet treat their attacks with icatibant significantly earlier and have markedly fewer severe or very severe attacks. Factors including regional access to and availability of icatibant may drive these outcomes and warrant further investigation.
Collapse
Affiliation(s)
- M Maurer
- Department of Dermatology and Allergy, Allergy Center Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K Bork
- Department of Dermatology, Johannes Gutenberg University, Mainz, Germany
| | | | - E Aygören-Pürsün
- Department for Children and Adolescents, Angioedema Centre, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | | | | | - M Magerl
- Department of Dermatology and Allergy, Allergy Center Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
6
|
Riedl MA, Aygören-Pürsün E, Baker J, Farkas H, Anderson J, Bernstein J, Bouillet L, Busse P, Manning M, Magerl M, Gompels M, Huissoon AP, Longhurst H, Lumry W, Ritchie B, Shapiro R, Soteres D, Banerji A, Cancian M, Johnston DT, Craig T, Launay D, Li HH, Liebhaber M, Nickel T, Offenberger J, Rae W, Schrijvers R, Triggiani M, Wedner HJ, Dobo S, Cornpropst M, Clemons D, Fang L, Collis P, Sheridan W, Maurer M. Evaluation of avoralstat, an oral kallikrein inhibitor, in a Phase 3 hereditary angioedema prophylaxis trial: The OPuS-2 study. Allergy 2018; 73:1871-1880. [PMID: 29688579 PMCID: PMC6175137 DOI: 10.1111/all.13466] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2018] [Indexed: 12/02/2022]
Abstract
Background Effective inhibition of plasma kallikrein may have significant benefits for patients with hereditary angioedema due to deficiency of C1 inhibitor (C1‐INH‐HAE) by reducing the frequency of angioedema attacks. Avoralstat is a small molecule inhibitor of plasma kallikrein. This study (OPuS‐2) evaluated the efficacy and safety of prophylactic avoralstat 300 or 500 mg compared with placebo. Methods OPuS‐2 was a Phase 3, multicenter, randomized, double‐blind, placebo‐controlled, parallel‐group study. Subjects were administered avoralstat 300 mg, avoralstat 500 mg, or placebo orally 3 times per day for 12 weeks. The primary efficacy endpoint was the angioedema attack rate based on adjudicator‐confirmed attacks. Results A total of 110 subjects were randomized and dosed. The least squares (LS) mean attack rates per week were 0.589, 0.675, and 0.593 for subjects receiving avoralstat 500 mg, avoralstat 300 mg, and placebo, respectively. Overall, 1 subject in each of the avoralstat groups and no subjects in the placebo group were attack‐free during the 84‐day treatment period. The LS mean duration of all confirmed attacks was 25.4, 29.4, and 31.4 hours for the avoralstat 500 mg, avoralstat 300 mg, and placebo groups, respectively. Using the Angioedema Quality of Life Questionnaire (AE‐QoL), improved QoL was observed for the avoralstat 500 mg group compared with placebo. Avoralstat was generally safe and well tolerated. Conclusions Although this study did not demonstrate efficacy of avoralstat in preventing angioedema attacks in C1‐INH‐HAE, it provided evidence of shortened angioedema episodes and improved QoL in the avoralstat 500 mg treatment group compared with placebo.
Collapse
Affiliation(s)
- M. A. Riedl
- Division of Rheumatology; Allergy & Immunology; University of California San Diego; San Diego CA USA
| | - E. Aygören-Pürsün
- Department for Children and Adolescents; University Hospital Frankfurt; Frankfurt Germany
| | - J. Baker
- Baker Allergy Asthma Dermatology Research Center; Portland OR USA
| | - H. Farkas
- 3rd Department of Internal Medicine; Semmelweis University; Budapest Hungary
| | - J. Anderson
- Clinical Research Center of Alabama; Birmingham AL USA
| | - J. A. Bernstein
- Department of Internal Medicine; University of Cincinnati; Cincinnati OH USA
| | - L. Bouillet
- Internal Medicine; National Reference Centre of Angioedema; Grenoble University Hospital; Grenoble France
| | - P. Busse
- Division of Clinical Immunology and Allergy; Department of Medicine; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - M. Manning
- Medical Research of Arizona; Allergy; Asthma & Immunology Associates; Scottsdale AZ USA
| | - M. Magerl
- Dermatology, Venerology and Allergology; Charite - Universitätsmedizin Berlin; Berlin Germany
| | - M. Gompels
- Immunology; North Bristol NHS Trust; Bristol UK
| | - A. P. Huissoon
- Department of Allergy and Immunology; Heartlands Hospital; Birmingham UK
| | - H. Longhurst
- Immunology; Addenbrookes Hospital; Cambridge University Hospitals; Cambridge UK
| | - W. Lumry
- Allergy and Asthma Research Associates Research Center; Dallas TX USA
| | - B. Ritchie
- Division of Hematology; Department of Medicine; University of Alberta; Edmonton AB Canada
| | - R. Shapiro
- Immunology; Midwest Immunology Clinic; Plymouth MN USA
| | - D. Soteres
- Asthma and Allergy Associates PC; Colorado Springs CO USA
| | - A. Banerji
- Division of Rheumatology; Allergy& Immunology; Department of Medicine; Massachusetts General Hospital; Harvard Medical School; Boston MA USA
| | - M. Cancian
- Department of Medicine; University of Padova; Padova Italy
| | | | - T. J. Craig
- Department of Medicine and Pediatrics; Penn State Hershey Allergy Asthma, and Immunology; Hershey PA USA
| | - D. Launay
- Internal Medicine; CHRU Lille; France France
| | - H. H. Li
- Institute for Asthma and Allergy; Chevy Chase MD USA
| | - M. Liebhaber
- Allergy and Immunology; Sansum Clinic; Santa Barbara CA USA
| | - T. Nickel
- Allergy & Immunology; Allergy Clinic of Tulsa; Tulsa OK USA
| | | | - W. Rae
- Allergy & Clinical Immunology; University Hospital Southampton NHS Foundation Trust; Southampton UK
| | - R. Schrijvers
- Laboratory of Clinical Immunology; KU Leuven; Leuven Belgium
| | - M. Triggiani
- Division of Allergy and Clinical Immunology; University of Salerno; Salerno Italy
| | - H. J. Wedner
- Division of Allergy and Immunology; Washington University School of Medicine; St. Louis MO USA
| | - S. Dobo
- Biocryst Pharmaceuticals; Durham NC USA
| | | | | | - L. Fang
- Statistics; PharStat, Inc.; Raleigh NC USA
| | - P. Collis
- Biocryst Pharmaceuticals; Durham NC USA
| | | | - M. Maurer
- Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| |
Collapse
|
7
|
Maurer M, Magerl M, Ansotegui I, Aygören-Pürsün E, Betschel S, Bork K, Bowen T, Balle Boysen H, Farkas H, Grumach AS, Hide M, Katelaris C, Lockey R, Longhurst H, Lumry WR, Martinez-Saguer I, Moldovan D, Nast A, Pawankar R, Potter P, Riedl M, Ritchie B, Rosenwasser L, Sánchez-Borges M, Zhi Y, Zuraw B, Craig T. The international WAO/EAACI guideline for the management of hereditary angioedema-The 2017 revision and update. Allergy 2018; 73:1575-1596. [PMID: 29318628 DOI: 10.1111/all.13384] [Citation(s) in RCA: 298] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 12/25/2022]
Abstract
Hereditary Angioedema (HAE) is a rare and disabling disease. Early diagnosis and appropriate therapy are essential. This update and revision of the global guideline for HAE provides up-to-date consensus recommendations for the management of HAE. In the development of this update and revision of the guideline, an international expert panel reviewed the existing evidence and developed 20 recommendations that were discussed, finalized and consented during the guideline consensus conference in June 2016 in Vienna. The final version of this update and revision of the guideline incorporates the contributions of a board of expert reviewers and the endorsing societies. The goal of this guideline update and revision is to provide clinicians and their patients with guidance that will assist them in making rational decisions in the management of HAE with deficient C1-inhibitor (type 1) and HAE with dysfunctional C1-inhibitor (type 2). The key clinical questions covered by these recommendations are: (1) How should HAE-1/2 be defined and classified?, (2) How should HAE-1/2 be diagnosed?, (3) Should HAE-1/2 patients receive prophylactic and/or on-demand treatment and what treatment options should be used?, (4) Should HAE-1/2 management be different for special HAE-1/2 patient groups such as pregnant/lactating women or children?, and (5) Should HAE-1/2 management incorporate self-administration of therapies and patient support measures?
Collapse
Affiliation(s)
- M. Maurer
- Department of Dermatology and Allergy; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - M. Magerl
- Department of Dermatology and Allergy; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - I. Ansotegui
- Department of Allergy and Immunology; Hospital Quironsalud Bizkaia; Bilbao Spain
| | - E. Aygören-Pürsün
- Center for Children and Adolescents; University Hospital Frankfurt; Frankfurt Germany
| | - S. Betschel
- Division of Clinical Immunology and Allergy; St. Michael's Hospital; University of Toronto; Toronto ON Canada
| | - K. Bork
- Department of Dermatology; Johannes Gutenberg University Mainz; Mainz Germany
| | - T. Bowen
- Department of Medicine and Pediatrics; University of Calgary; Calgary AB Canada
| | | | - H. Farkas
- Hungarian Angioedema Center; 3rd Department of Internal Medicine; Semmelweis University; Budapest Hungary
| | - A. S. Grumach
- Clinical Immunology; Faculdade de Medicina ABC; São Paulo Brazil
| | - M. Hide
- Department of Dermatology; Hiroshima University; Hiroshima Japan
| | - C. Katelaris
- Department of Medicine; Campbelltown Hospital and Western Sydney University; Sydney NSW Australia
| | - R. Lockey
- Department of Internal Medicine; University of South Florida Morsani College of Medicine; Tampa FL USA
| | - H. Longhurst
- Department of Clinical Biochemistry and Immunology; Addenbrooke's Hospital; Cambridge University Hospitals NHS Foundation Trust; UK
| | - W. R. Lumry
- Department of Internal Medicine; Allergy/Immunology Division; Southwestern Medical School; University of Texas; Dallas TX USA
| | | | - D. Moldovan
- University of Medicine and Pharmacy; Tîrgu Mures Romania
| | - A. Nast
- Berlin Institute of Health; Department of Dermatology, Venereology und Allergy; Division of Evidence based Medicine (dEBM); Corporate Member of Freie Universität Berlin; Humboldt-Universität zu Berlin; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - R. Pawankar
- Department of Pediatrics; Nippon Medical School; Tokyo Japan
| | - P. Potter
- Department of Medicine; University of Cape Town; Cape Town South Africa
| | - M. Riedl
- Department of Medicine; University of California-San Diego; La Jolla CA USA
| | - B. Ritchie
- Division of Hematology; University of Alberta; Edmonton AB Canada
| | - L. Rosenwasser
- Allergy and Immunology Department; University of Missouri at Kansas City School of Medicine; Kansas City MO USA
| | - M. Sánchez-Borges
- Allergy and Clinical Immunology Department; Centro Medico Docente La Trinidad; Caracas Venezuela
| | - Y. Zhi
- Department of Allergy; Peking Union Medical College Hospital and Chinese Academy of Medical Sciences; Beijing China
| | - B. Zuraw
- Department of Medicine; University of California-San Diego; La Jolla CA USA
- San Diego VA Healthcare; San Diego CA USA
| | - T. Craig
- Department of Medicine and Pediatrics; Penn State University; Hershey PA USA
| |
Collapse
|
8
|
Ehrenforth S, Aygören-Pürsün E, Hach-Wunderle V, Scharrer I. Prevalence of Elevated Histidine-Rich Glycoprotein in Patients with Thrombophilia - a Study of 695 Patients. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1642405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S Ehrenforth
- J. W. Goethe University Hospital, Frankfurt, Germany
| | | | | | - I Scharrer
- J. W. Goethe University Hospital, Frankfurt, Germany
| |
Collapse
|
9
|
Zanichelli A, Longhurst HJ, Maurer M, Bouillet L, Aberer W, Fabien V, Andresen I, Caballero T, Grumach A, Bygum A, Blanchard Delaunay C, Bouillet L, Coppere B, Fain O, Goichot B, Gompel A, Guez S, Jeandel P, Kanny G, Launay D, Maillard H, Martin L, Masseau A, Ollivier Y, Sobel A, Arnolds J, Aygören-Pürsün E, Baş M, Bauer A, Bork K, Martinez I, Maurer M, Papadopoulou-Alataki E, Psarros F, Graif Y, Kivity S, Reshef A, Toubi E, Arcoleo F, Cicardi M, Manconi P, Marone G, Montinaro V, Baeza M, Caballero T, Cabañas R, Guilarte M, Hernandez de Rojas D, Hernando de Larramendi C, Lleonart R, Lobera T, Sáenz de San Pedro B, Bjorkander J, Helbert M, Longhurst H. Misdiagnosis trends in patients with hereditary angioedema from the real-world clinical setting. Ann Allergy Asthma Immunol 2017; 117:394-398. [PMID: 27742086 DOI: 10.1016/j.anai.2016.08.014] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/05/2016] [Accepted: 08/10/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) causes swelling in the skin and upper airways and pain in the abdomen because of mucosal swelling. C1-INH-HAE is frequently misdiagnosed, leading to delays in diagnosis, inadequate treatment, and unnecessary procedures. OBJECTIVE To evaluate the history of misdiagnosis in patients participating in the Icatibant Outcome Survey (IOS). METHODS The IOS is an observational study in which safety and effectiveness of icatibant have been evaluated since 2009. As part of the IOS, patients record any misdiagnoses received before being diagnosed as having C1-INH-HAE. RESULTS In January 2016, a total of 418 of 633 IOS patients with C1-INH-HAE type I or II had provided misdiagnosis data. Of these, 185 of 418 (44.3%) received 1 or more prior misdiagnoses. The most common misdiagnoses were allergic angioedema (103 of 185) and appendicitis (50 of 185). A variety of other misdiagnoses were reported, including a substantial number of gastrointestinal disorders (excluding appendicitis). Misdiagnosis rates were similar between males (41.1%) and females (46.5%) and between C1-INH-HAE type I (43.7%) and type II (51.6%). Patients with family members diagnosed as having C1-INH-HAE were significantly less likely to be misdiagnosed than patients without a family history (140 of 366 [41.7%] vs 38 of 58 [65.5%], respectively; P = .001). Patients with a prior misdiagnosis had longer median delay to C1-INH-HAE diagnosis (13.3 years) than patients without (1.7 years; P < .001). CONCLUSION From this large database, approximately 50% of patients with C1-INH-HAE type I or II have previously had their conditions misdiagnosed, most commonly as allergic angioedema or appendicitis. Misdiagnosis results in marked delays in receiving the correct diagnosis, during which time patients cannot access effective, lifesaving treatment. TRIAL REGISTRATION ClinicalTrials.gov: NCT01034969.
Collapse
Affiliation(s)
- Andrea Zanichelli
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy.
| | - Hilary J Longhurst
- Department of Immunology, Barts Health NHS Trust, London, United Kingdom
| | - Marcus Maurer
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Laurence Bouillet
- National Reference Centre for Angioedema, Internal Medicine Department, Grenoble University Hospital, Grenoble, France
| | - Werner Aberer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | | | | | - Teresa Caballero
- Allergy Department, Hospital La Paz Institute for Health Research, Biomedical Research Network on Rare Diseases (CIBERER, U754), Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Soteres D, Jacobson K, Moldovan D, Christensen J, Van Leerberghe A, Wang Y, Schranz J, Aygören-Pürsün E, Martinez-Saguer I. P088 Pharmacokinetics/pharmacodynamics of C1 inhibitor for prevention of angioedema attacks in children with hereditary angioedema (HAE). Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
11
|
Martinez-Saguer I, Klarmann D, Knöfler R, Escurila-Ettingshausen C, Funk M, Linde R, Aygören-Pürsün E, Stoll H, Klingebiel T, Kreuz W. Successful immune tolerance therapy in hemophilia B patients with fix - a new immunesuppressive strategy. J Thromb Haemost 2014. [DOI: 10.1111/j.1538-7836.2003.tb04233.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
12
|
Boysen H, Bouillet L, Aygören-Pürsün E. Challenges of C1-Inhibitor Concentrate Self-Administration. Int Arch Allergy Immunol 2013; 161 Suppl 1:21-5. [DOI: 10.1159/000351238] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Self-administration of therapy can help hereditary angioedema (HAE) patients regain control of their disease or reduce its impact and improve the quality of their lives. However, data from a self-administration survey, and subsequent discussion at an international HAE expert meeting, identified several barriers to self-administration therapy. These barriers include difficulty in administration technique, availability of nursing resources and the mental capacity of the patient. Encouragingly, international HAE experts identified that once a patient has acquired self-administration skills, they generally retain them in the long-term. As patient uptake increases, it was recommended that follow-up management plans should be established to address any issues from the patient's perspective.
Collapse
|
13
|
Dewald G, Aygören-Pürsün E, Martinez Saguer I, Rusicke E, Kreuz W. Idiopathic Angioedema and Coagulation Factor XII Mutation. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
14
|
Martinez-Saguer I, Cicardi M, Aygören-Pürsün E, Rusicke E, Klingebiel T, Kreuz W. Pharmacokinetic Berinert P Study Of Subcutaneous Versus Intravenous Administration In Subjects With Moderate Hereditary Angioedema - The Passion Study. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
Aygören-Pürsün E, Martinez Saguer I, Rusicke E, Kreuz W. Risk of Angioedema following operative and invasive Procedures in Hereditary Angioedema due to C1-inhibitor Deficiency. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.1059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
16
|
Aygören-Pürsün E, Dewald G, Rusicke E, Saguer IM, Kreuz W. Hereditary Angioedema due to Missense Mutations Thr309Lys and Thr309Arg in the Factor 12 Gene. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
17
|
Rusicke E, Martinez-Saguer I, Aygören-Pürsün E, Klingebiel T, Kreuz W. Short-term Prophylaxis With C1-inhibitor Concentrate In Patients With Hereditary Angioedema Prior To Surgical Procedures. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Martinez-Saguer I, Rusicke E, Aygören-Pürsün E, Klingebiel T, Kreuz W. Management Of Hae Patients During Pregnancy And Delivery - A Prospective Evaluation Of 35 Pregnancies And 37 Newborns. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
19
|
|
20
|
Martinez-Saguer I, Rusicke E, Aygören-Pürsün E, Klingebiel T, Kreuz W. Clinical Surveillance Program Of Pediatric Hereditary Angioedema (HAE) Patients Undergoing Home Treatment. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
21
|
Gösswein T, Kocot A, Emmert G, Kreuz W, Martinez-Saguer I, Aygören-Pürsün E, Rusicke E, Bork K, Oldenburg J, Müller CR. Mutational spectrum of the C1INH (SERPING1) gene in patients with hereditary angioedema. Cytogenet Genome Res 2008; 121:181-8. [PMID: 18758157 DOI: 10.1159/000138883] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2008] [Indexed: 11/19/2022] Open
Abstract
Hereditary angioedema (HAE) is an autosomal dominant disease that manifests as intermittent acute swellings of the skin and mucosal surfaces, which, in the gastrointestinal tract and larynx, may even be fatal. HAE results from functional deficiency of the C1 inhibitor (C1INH) protein, which plays a key role in the classical pathway of complement activation. C1INH is the sole inhibitor of the activated proteases C1r and C1s, and is the major regulator of activated coagulation Factor XII and plasma kallikrein, which limits the generation of the vasoactive peptide bradykinin. In this paper, we report on the genetic analysis of 173 families (including 326 members) with a clinical diagnosis of HAE. Direct sequencing, Southern blotting and quantitative PCR by the MLPA method were used to screen for mutations in C1INH (SERPING1). In 142 families (82.1%), a causative C1INH gene mutation could be identified. A total of 80 novel point mutations of C1INH not published previously were detected in 96 pedigrees (including 172 members). Our results corroborate C1INH (SERPING1) deficiency as a disease of extreme allelic heterogeneity with almost each individual family carrying their own mutation. Routine molecular genetic analysis is an effective way of confirming the clinical diagnosis and identifying mutation carriers early on before any clinical manifestation becomes apparent. It is, therefore, a valuable tool in prevention and adequate treatment of acute and life-threatening oedema.
Collapse
Affiliation(s)
- T Gösswein
- Department of Human Genetics, University of Wurzburg, Wurzburg, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Aygören-Pürsün E, Martinez Saguer I, Rusicke E, Louwen F, Geka F, Ivaskevicius V, Oldenburg J, Klingebiel T, Kreuz W. Retrochorionic hematoma in congenital afibrinogenemia: resolution with fibrinogen concentrate infusions. Am J Hematol 2007; 82:317-20. [PMID: 17034026 DOI: 10.1002/ajh.20802] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Without treatment, pregnancies in patients with congenital afibrinogenemia terminate in miscarriage at 5-6 weeks of gestation. Animal model studies have suggested that implantation site bleeding contributes to miscarriage in afibrinogenemia; however, retrochorionic hematoma in human congenital afibrinogenemia has not been previously observed. A patient with congenital afibrinogenemia receiving fibrinogen prophylaxis developed a retrochorionic hematoma in the first trimester. With continuous intensified fibrinogen concentrate replacement the hematoma resolved over 6 weeks, and the patient delivered a healthy infant. Median fibrinogen levels in the first trimester were 48 mg/dL and in second and third trimester 44 mg/dL. Median fibrinogen levels under 60 mg/dL may be adequate to maintain pregnancy in patients with congenital afibrinogenemia, although it is possible that higher levels might reduce the risk of hemorrhagic events.
Collapse
Affiliation(s)
- E Aygören-Pürsün
- Department of Pediatric Hematology, Oncology and Hemostasis, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Rusicke E, Martinez-Saguer I, Aygören-Pürsün E, Klingebiel T, Kreuz W. Intraindividual And Interindividual Variations Of Symptoms In Patients With Hereditary Angioedema. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.12.593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
24
|
Martinez-Saguer I, Rusicke E, Aygören-Pürsün E, Kreuz W. Pharmacokinetics of Pasteurized C1-Inhibitor Concentrate (Berinert P) in 40 Patients with Hereditary Angioedema. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
25
|
|
26
|
Martinez-Saguer I, Rusicke E, Aygören-Pürsün E, Kreuz W. Individual Replacement Therapy (IRT) with a Pasteurized C1-Inhibitor Concentrate Compared to Prophylaxis with Danazol in Patients with Hereditary Angioedema (HAE) - A Prospective Study. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
27
|
Ehrenforth S, von Depka Prondsinski M, Aygören-Pürsün E, Nowak-Göttl U, Scharrer I, Ganser A. Study of the prothrombin gene 20201 GA variant in FV:Q506 carriers in relationship to the presence or absence of juvenile venous thromboembolism. Arterioscler Thromb Vasc Biol 1999; 19:276-80. [PMID: 9974407 DOI: 10.1161/01.atv.19.2.276] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The G20210A transition of the prothrombin gene has been identified as a common but probably mild hereditary risk factor for venous thromboembolism (VTE). However, the prothrombin gene variant might contribute to the penetrance of thromboembolic disease in many patients with other prothrombotic defects, such as the FV:R506Q mutation. In this investigation, the A20210 allele was found in 9 of 450 healthy controls (2%). Among 89 asymptomatic FV:Q506 carriers, 3 subjects were doubly affected (3.4%). In contrast, of 263 unrelated carriers of the FV:Q506 mutant with a history of juvenile VTE, 30 also had the prothrombin gene G20210A variant (11.4%), including 25 of 220 patients who were heterozygous (11.4%) and 5 of 43 homozygous (11.6%) for FV:Q506. Thus, the A20210 allele of the prothrombin gene is significantly overrepresented in symptomatic FV:Q506 carriers compared with healthy controls (P<0.0001) and asymptomatic relatives carrying the FV mutant (P=0.02). Persons homozygous for the 20210A allele were not found. A statistically significant increase in the prevalence of more unusual sites of venous thrombosis at clinical onset was found in doubly affected patients (9 of 30; 30%) compared with patients without the prothrombin gene variant (26 of 233; 11. 1%) (P=0.004). First VTE occurred spontaneously in 53.3% of all doubly affected patients (16 of 30) and in 28.3% of all simply affected patients (66 of 233) (P=0.005). Among patients with VTE preceded by circumstantial risk factors, the A20210 allele was found in 7.7% (14 of 181). We conclude that the A20210 allele of the prothrombin gene is frequently coinherited in symptomatic FV:Q506 carriers and possibly influences age, site, and type of thrombotic onset manifestation in these patients.
Collapse
Affiliation(s)
- S Ehrenforth
- Department of Internal Medicine, University Hospital, Frankfurt am Main, Germany.
| | | | | | | | | | | |
Collapse
|
28
|
Aygören-Pürsün E, Scharrer I. A multicenter pharmacosurveillance study for the evaluation of the efficacy and safety of recombinant factor VIII in the treatment of patients with hemophilia A. German Kogenate Study Group. Thromb Haemost 1997; 78:1352-6. [PMID: 9408018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In this open multicenter study the safety and efficacy of recombinant factor VIII (rFVIII) was assessed in 39 previously treated patients with hemophilia A (factor VIII basal activity < or = 15%). Recombinant FVIII was administered for prophylaxis and treatment of bleeding episodes and for surgical procedures. A total of 3679 infusions of rFVIII were given. Efficacy of rFVIII as assessed by subjective evaluation of response to infusion and mean annual consumption of rFVIII was comparable to that of plasma derived FVIII concentrates. The incremental recovery of FVIII (2.4 +/- 0.83%/IU/kg, 2.12 +/- 0.61%/IU/kg, resp.) was within the expected range. No clinical significant FVIII inhibitor was detected in this trial. Five of 16 susceptible patients showed a seroconversion for parvovirus B19. However, the results are ambiguous in two cases and might be explained otherwise in one further case. Thus, in two patients a reliable seroconversion for parvovirus B19 was observed.
Collapse
Affiliation(s)
- E Aygören-Pürsün
- Center of Internal Medicine, University Hospital, Frankfurt, Germany
| | | |
Collapse
|
29
|
Abstract
The virally inactivated pasteurized FVIII concentrate Haemate P contains nearly intact vWF multimers. It is currently the treatment of choice to achieve satisfactory hemostasis for moderate to severe vWD and for patients with variants of vWD that cannot be adequately treated with DDAVP or for whom DDAVP is contraindicated. Therefore, we treated patients with type Ia, type IIa, type IIb and type III vWD with Haemate P. A correction of the hemostatic defect was seen in all patients. The type of bleeding events included 24 gastrointestinal, 18 other mucosal, 5 central nervous system, 15 orthopedic and 4 other. 28 dental surgical procedures, 9 operative deliveries, 5 tonsillectomies, 17 orthopedic and 11 miscellaneous surgeries were performed under the cover of Haemate P.
Collapse
Affiliation(s)
- I Scharrer
- Center of Internal Medicine, University Hospital, Frankfurt, Germany
| | | | | |
Collapse
|
30
|
Ehrenforth S, Aygören-Pürsün E, Hach-Wunderle V, Scharrer I. Prevalence of elevated histidine-rich glycoprotein in patients with thrombophilia--a study of 695 patients. Thromb Haemost 1994; 71:160-1. [PMID: 8165641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|