Yeich Andrew, Elhatw Ahmed, Ashoor Zaynab, Park Kristen, Craig Timothy
Department of Allergy, Asthma and Immunology, Medical Student, Penn State College of Medicine, Hershey, PA, USA.
Department of Allergy, Asthma and Immunology, Resident, Cairo University School of Medicine, Giza, Egypt.
Expert Opin Drug Saf. 2023 Jan;22(1):17-24. doi: 10.1080/14740338.2023.2177269. Epub 2023 Feb 15.
Hereditary Angioedema (HAE) attacks show an increased frequency and severity for pregnant and lactating females secondary to the hormonal changes. The diagnosis and management of HAE in pregnant and lactating females pose a challenge for physicians due to the rarity of the disease and the paucity of the data for specific management.
In this manuscript, we discuss the diagnosis and special presentation of HAE types 1 and 2 in pregnant and lactating females, including acute management, short-term prophylaxis, long-term prophylaxis, and drugs that should be avoided. Relevant publications were found through key word search of papers indexed in both Google Scholar and PubMed on 1 July 2022.
Treatment of HAE in the past has been mainly provided by experts; however, with more medications and an increasing number of patients, knowledge of how to care for HAE patients during pregnancy and lactation is important to review. Despite approval of additional medications in many countries, plasma-derived C1-inhibitor remains the drug of first choice for treatment in this unique population. Additional research is needed to increase safe access to other therapy options. We hope that future clinical studies, registries, and databases will shed additional light on this subject.
由于激素变化，遗传性血管性水肿（HAE）发作在怀孕和哺乳期女性中频率增加且病情加重。由于该疾病罕见且缺乏特定管理的数据，怀孕和哺乳期女性HAE的诊断和管理给医生带来了挑战。
在本手稿中，我们讨论了1型和2型HAE在怀孕和哺乳期女性中的诊断及特殊表现，包括急性管理、短期预防、长期预防以及应避免使用的药物。通过在2022年7月1日对谷歌学术和PubMed索引的论文进行关键词搜索，找到了相关出版物。
过去HAE的治疗主要由专家提供；然而，随着药物增多和患者数量增加，审查如何在怀孕和哺乳期照顾HAE患者的知识很重要。尽管许多国家批准了更多药物，但血浆源性C1抑制剂仍然是这一特殊人群治疗的首选药物。需要进行更多研究以增加安全获取其他治疗选择的机会。我们希望未来的临床研究、登记处和数据库将对此主题提供更多见解。
