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Clin Exp Immunol. 2015 Jun;180(3):475-83. doi: 10.1111/cei.12584. Epub 2015 May 13.

C1 inhibitor deficiency: 2014 United Kingdom consensus document.

Clinical and experimental immunology

H J Longhurst, M D Tarzi, F Ashworth, C Bethune, C Cale, J Dempster, M Gompels, S Jolles, S Seneviratne, C Symons, A Price, D Edgar

Affiliations

  1. Department of Immunology, Barts Health NHS Trust and Medical Adviser HAE, UK.
  2. Department of Medicine, Brighton and Sussex Medical School, Brighton, UK.
  3. Department of Immunology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
  4. Department of Immunology, Plymouth Hospitals NHS Trust, Plymouth, UK.
  5. Department of Immunology, Great Ormond Street Hospital for Children, London, UK.
  6. Department of Immunology, North Bristol NHS Trust, Bristol, UK.
  7. Department of Immunology, University Hospital of Wales, Cardiff, UK.
  8. Department of Immunology, Royal Free London NHS Trust, London, UK.
  9. Herditary Angioedema, UK (HAE UK).
  10. UK Primary Immunodeficiency Network (UK PIN), Newcastle upon Tyne, UK.

PMID: 25605519 PMCID: PMC4449776 DOI: 10.1111/cei.12584

Abstract

C1 inhibitor deficiency is a rare disorder manifesting with recurrent attacks of disabling and potentially life-threatening angioedema. Here we present an updated 2014 United Kingdom consensus document for the management of C1 inhibitor-deficient patients, representing a joint venture between the United Kingdom Primary Immunodeficiency Network and Hereditary Angioedema UK. To develop the consensus, we assembled a multi-disciplinary steering group of clinicians, nurses and a patient representative. This steering group first met in 2012, developing a total of 48 recommendations across 11 themes. The statements were distributed to relevant clinicians and a representative group of patients to be scored for agreement on a Likert scale. All 48 statements achieved a high degree of consensus, indicating strong alignment of opinion. The recommendations have evolved significantly since the 2005 document, with particularly notable developments including an improved evidence base to guide dosing and indications for acute treatment, greater emphasis on home therapy for acute attacks and a strong focus on service organization.

© 2015 The Authors. Clinical & Experimental Immunology published by John Wiley & Sons Ltd on behalf of British Society for Immunology.

Keywords: C1 inhibitor deficiency; HAE; guidelines; hereditary angioedema

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