Staikuniene-Kozonis Jurate, Staikunaite Juste, Gasiuniene Edita, Sematonyte Justina
Department of Immunology and Allergology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
JSC CD8 Clinic, Kaunas, Lithuania.
Front Pediatr. 2024 Jun 24;12:1408110. doi: 10.3389/fped.2024.1408110. eCollection 2024.
Hereditary angioedema (HAE) is a rare autosomal-dominant disease that is caused by a deficiency (type I) or dysfunction (type II) of the C1 inhibitor (C1-INH) due to a mutation in the gene, which codes for C1-INH. HAE with quantitatively and qualitatively normal C1-INH (type III) is often caused by a mutation in the gene and no mutations in the gene and is a group of very rare diseases. The C1 esterase inhibitor (C1-INH) is a major regulator of critical enzymes that are implicated in the cascades of bradykinin generation, which increases vascular permeability and allows the flow of fluids into the extracellular space, resulting in angioedema. HAE clinically manifests with intermittent attacks of swelling of the subcutaneous tissue or submucosal layers of the respiratory and gastrointestinal tract. Young children are typically asymptomatic, and those affected by HAE usually present with symptoms in their early 20s. This article describes the case of very early onset of hereditary angioedema caused by C1-INH deficiency in a 2-year-old boy who experienced recurrent episodes of hand and abdominal angioedema not associated with urticaria or pruritus. His father suffered from severe HAE due to a mutation of the gene. The same mutation of the gene was detected in his son at the age of 9-months prior to the occurrence of angioedema symptoms, during genetic family counseling. This paper advances the understanding of HAE and highlights the importance of genetic counseling of families with HAE to avoid late or inaccurate diagnosis and to initiate treatment on time.
遗传性血管性水肿(HAE)是一种罕见的常染色体显性疾病,由编码C1抑制剂(C1-INH)的基因突变导致C1抑制剂缺乏(I型)或功能障碍(II型)引起。C1-INH在数量和质量上均正常的HAE(III型)通常由该基因的突变引起,而该基因无突变,是一组非常罕见的疾病。C1酯酶抑制剂(C1-INH)是关键酶的主要调节因子,这些酶参与缓激肽生成级联反应,增加血管通透性,使液体流入细胞外间隙,导致血管性水肿。HAE的临床症状表现为皮下组织或呼吸道和胃肠道黏膜下层间歇性肿胀发作。幼儿通常无症状,HAE患者通常在20岁出头出现症状。本文描述了一名2岁男孩因C1-INH缺乏导致遗传性血管性水肿非常早发的病例,该男孩反复出现手部和腹部血管性水肿,与荨麻疹或瘙痒无关。他的父亲因该基因突变患有严重的HAE。在遗传咨询期间,在其儿子9个月大、血管性水肿症状出现之前检测到相同的基因突变。本文增进了对HAE的理解,并强调了对HAE家庭进行遗传咨询的重要性,以避免诊断延迟或不准确,并及时开始治疗。