Presentation: Asymptomatic bacteruria increases the risk of edematous attacks in patients with hereditary angioedema due to C1 inhibitor deficency (C1-INH-HAE) ( World Allergy Congress)

Saturday, 17 October 2015

Hall D1 Foyer (Floor 3) (Coex Convention Center)

Zsuzsanna Zotter, MD , Urology and Andrology Department, Hungarian Defence Forces, Medical Center, Budapest, Hungary

Lilian Varga, PhD , 3rd Department of Internal Medicine, Hungarian Angioedema Center, Semmelweis University, Budapest, Hungary

Nora Veszeli, MSc , 3rd Department of Internal Medicine, Hungarian Angioedema Center, Semmelweis University, Budapest, Hungary

Eva Imreh, MD PhD , Central Laboratory, Kútvölgyi Clinical Center, Semmelweis University, Budapest, Hungary

Gabor Kovacs, MD , Urology and Andrology Department, Hungarian Defence Forces, Medical Center, Budapest, Hungary

Marsel Nallbani, MD , Urology and Andrology Department, Hungarian Defence Forces, Medical Center, Budapest, Hungary

Henriette Farkas, MD, PhD, DSc , 3rd Department of Internal Medicine, Hungarian Angioedema Center, Semmelweis University, Budapest, Hungary

Introduction: Although urinary tract infections (UTIs) are considered among the most common infectious disorders in humans, these usually follow an uncomplicated course. Various infections may have a role in inducing HAE attacks. Further, danazol treatment has been associated with hematuria. Our study intended to evaluate the abnormalities of the urinalysis of C1-INH-HAE patients.

Methods: Urine specimens contributed by 139 C1-INH-HAE patients at the annual control visits were studied retrospectively (RBC and WBC counts, microorganisms). We analyzed these laboratory parameters in relation of the clinical symptoms and in view of the long-term danazol therapy.

Results: Taking into account 3 randomly selected urine specimens, we found that the cumulative number of edematous attacks was higher in patients with than in those without bacteriuria (p=0.019, p=0.022, p=0.014). Considering the same patients (n=76), attack number was significantly higher (14.51 vs. 8.63) in patients with than in those without bacteriuria (p<0.0001). The cumulative incidence of microhematuria found upon a single or repeated examination was 74,8% after the annual check-up per patient. Taking into account an observation period of 3 years, the alterations detected in the urinary sediment were unrelated to treatment with or the dose of danazol.

Conclusion: The cumulative incidence of microhematuria was substantially higher compared with the historical data of healthy individuals. As regards the background of this phenomenon, we did not found any relationship with danazol therapy. The main finding of our study was that the increase incidence of edema was associated with bacteriuria. This finding emphasizes the triggering role of bacteriuria in the occurrence of edematous episodes.

Supported by OTKA grant 100886 and 112110.

4030 Asymptomatic bacteruria increases the risk of edematous attacks in patients with hereditary angioedema due to C1 inhibitor deficency (C1-INH-HAE)