Clinical outcomes of dental procedures in patients with hereditary angioedema

Objective: To investigate the relationship between angioedema (AE) attacks and dental procedures in patients with hereditary angioedema (HAE) and to identify potential risk factors. Patients and Methods: Patients diagnosed with HAE between 1999 and 2024 at a tertiary adult allergy clinic were retrospectively reviewed for dental procedures and AE attacks. Results: Of 102 HAE patients, 74 were included after excluding 28 with incomplete data. Dental procedures were performed in 47 patients (63.5%), totaling 85 interventions, most commonly tooth extractions (50.6%), restorations (34.1%), and root canal treatments (11.8%). Preprocedural prophylaxis was administered in 46 cases (54.1%), primarily with plasma-derived C1-inhibitor (pdC1-INH) (n = 36), followed by danazol (n = 7) and icatibant (n = 3). A total of 17 AE attacks (20%) were recorded, all involving the oropharyngeal region. Prophylaxis significantly reduced attack rates (p = 0.022), with no significant difference between pdC1-INH and danazol (p = 0.572). In the pdC1-INH group, attack rates were similar for 500 IU and 1000 IU doses (11.1% vs. 14.8%, p = 0.781). Conclusion: Preprocedural prophylaxis reduced AE attack frequency in dental procedures, with similar outcomes for pdC1-INH and danazol. Similar results were also observed between 500 IU and 1000 IU pdC1-INH.