A case of tooth extraction in a patient with hereditary angioedema

Hereditary angioedema(HAE)is a rare disease caused by functional disorder or a reduction in C1inhibitor(C1-INH). HAE was first described by Osler in 1888. Dental treatment and oral surgery in HAE patients can trigger life-threatening laryngeal edema. C1-INH is effective for both the prevention of HAE and the treatment of acute attacks. Since C1-INH is a blood product and very expensive in Japan, C1-INH should be used carefully.Other drugs or methods should also be considered to prevent attacks of HAE.We report a male patient with HAE who required tooth extraction. To prevent angioedema associated with tooth extraction, the patient was given tranexamic acid before operation. He underwent tooth extraction after receiving intravenous propofol and midazolam. He was observed during the night after the operation and was discharged from the hospital the next morning, without any complications.