acquired (acquired angioedema, AAE). Substitutive therapy with C1-INH concentrate is the treatment of choice for severe acute attacks of angioedema in Europe. METHODS: We report the need and effect of C1-INH concentrate in 448 patients with HAE and 25 with AAE. Time to beginning of resolution of attacks, side effects were recorded. RESULTS: We recorded 326 infusions of C1 inhibitor plasma concentrate in 127 HAE patients (mean infusion/patient 2.5, range 1-17) and 89 infusion in 8 AAE patients (mean infusion/patient 11.1, range 1-27). Dose of concentrate ranged from 500U to 2000U for HAE, 1000U-12000U for AAE. Time to beginning of resolution was 1 hour in 303 (93%), between 1 and 2 hours in 7 and between 2 and 12 hours in the remaining 16 patients. One HAE patient underwent tracheostomy for laryngeal edema despite treatment with C1-INH concentrate. In 5 patients with AAE (54 infusions) beginning of resolution was always within one hour; in the remaining 3 patients (35 infusions) the response became progressively slow 3 (3 hours or more) requiring higher doses of C1-INH concentrate. One anaphylactic reaction and 2 generalized cutaneous reactions were reported in 2 patients with HAE. Transmission of HCV has been recorded before introduction of virucidal methods. CONCLUSIONS: C1 inhibitor concentrate is effective and safe for treatment of severe symptoms in the majority of patients with HAE. Patients with AAE may become resistant to the treatment.
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C1 Inhibitor Concentrate Therapy in 473 Patients With Hereditary and Acquired Angioedema
L. C. Zingale, A. Zanichelli, L. Maggioni, M. Cicardi; Internal Medicine, University of Milan, Milan, ITALY. RATIONALE: C1 inhibitor deficiency is a rare, potentially lethal condition that can be either inherited (hereditary angioedema, HAE) or