Allergy Asthma Respir Dis.  2014 Sep;2(4):277-284. 10.4168/aard.2014.2.4.277.

Clinical experience in managing patients with hereditary angioedema in Korea: questionnaire survey and a literature review

• Lee SY
• Kang HR
• Jung JW
• Jang GC
• Lee SY
• Ahn Y
• Min KU
• Korean Academy of Asthma, Allergy and Clinical Immunology Anaphylaxis Work Group

• KMID: 2262396
• DOI: http://doi.org/10.4168/aard.2014.2.4.277

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.

Keyword

Hereditary angioedema; Questionnaires; Korea; disease management

MeSH Terms

Allergy and Immunology
Angioedema
Angioedemas, Hereditary*
Asthma
Surveys and Questionnaires
Diagnosis
Disease Management
Education
Electronic Mail
Humans
Hypersensitivity
Korea
Orphan Drug Production
Surveys and Questionnaires

Figure

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  Fig. 1 Age distribution of respondents.

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  Fig. 2 Diagnostic methods for cases suspected as a hereditary angioedema (multiple responses were allowed). C1 INH, C1 inhibitor.

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  Fig. 3 Drugs ever used for the maintenance treatment of hereditary angioedema by respondents (multiple responses were allowed). C1 INH, C1 inhibitor; FFP, fresh frozen plasma; EACA, ε-aminocaproic acid.

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  Fig. 4 Drugs that respondents answered as agents for the acute attack (dark gray) and the maintenance or prophylactic treatment (light gray) (multiple responses were allowed). C1 INH, C1 inhibitor; FFP, fresh frozen plasma; EACA, ε-aminocaproic acid.

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