Pedraz J, Daudén E, García-Diez A
Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, España.
Actas Dermosifiliogr. 2007 May;98(4):240-9.
C1 inhibitor deficiency is a rare syndrome clinically characterized by recurrent episodes of swelling of subcutaneous tissue or angioedema. It can involve the skin, upper respiratory airways and abdomen. There are two main types: hereditary and acquired. Angioedema can involve practically any part of the cutaneous surface, it can cause lethal laryngeal edema and can present as gastrointestinal obstruction. The attacks can be triggered, in general, by trauma, drugs or infections. Diagnosis is confirmed by decreased serum levels of C4 and absence or marked decrease of the level or function of C1 inhibitor. Commonly employed drugs for prophylaxis and treatment of these patients include anabolic steroids, antifibrinolytic agents, and infusion of C1 inhibitor concentrate. Fresh frozen plasma is an option to be considered for short term prophylaxis or treatment of the acute attack. It is convenient to know this syndrome as it is a potentially life-threatening disease. Diagnosis of this rare syndrome is based on clinical features and characteristic alterations of laboratory tests. The acute attack should be treated as quickly as possible. Prophylactic therapy is indicated in certain circumstances (dental procedures, oral surgery).
C1 酯酶抑制剂缺乏症是一种罕见综合征,临床特征为皮下组织反复肿胀或血管性水肿发作。它可累及皮肤、上呼吸道和腹部。主要有两种类型:遗传性和获得性。血管性水肿几乎可累及皮肤表面的任何部位,可导致致命的喉水肿,并可表现为胃肠道梗阻。一般来说,发作可由创伤、药物或感染引发。通过血清 C4 水平降低以及 C1 酯酶抑制剂水平或功能缺失或显著降低来确诊。用于这些患者预防和治疗的常用药物包括合成代谢类固醇、抗纤维蛋白溶解剂以及输注 C1 酯酶抑制剂浓缩物。新鲜冷冻血浆可作为短期预防或急性发作治疗的一种选择。了解这种综合征很有必要,因为它是一种潜在的危及生命的疾病。这种罕见综合征的诊断基于临床特征和实验室检查的特征性改变。急性发作应尽快治疗。在某些情况下(牙科手术、口腔外科手术)需进行预防性治疗。