D-dimer elevation during tranexamic acid therapyand the debate on the therapeutic approach in hereditaryangioedema type I


Özdemiral C., Cagdas D. N.

ALERGOLOGIA POLSKA-POLISH JOURNAL OF ALLERGOLOGY, vol.10, no.1, pp.63-67, 2023 (SCI-Expanded)

Abstract

Hereditary angioedema type 1 (HAE-1) is the most prevalent HAE type, and it results from decreased antigenic 

C1 inhibitor (C1-INH) levels or function. Bradykinin-mediated angioedema in the face, trunk, extremities, 

genitalia, gastrointestinal tract, and upper airway are the symptoms of this rare and potentially fatal disease. 

PD-C1-INH concentrates, recombinant C1-INH, tranexamic acid (TXA), danazol, icatibant, ecallantide, and 

fresh-frozen plasma (FFP) may be used for treatment. The focus of this article is to point out D-dimer elevation 

during TXA use. We detected d-dimer elevation incidentally in 2 patients with hereditary angioedema (HAE) 

type 1 during tranexamic acid (TXA) therapy, in whom elevations were normalized a week after suspended 

TXA. However, the TXA treatment is expected to decrease D-dimer levels in surgery and hyperfibrinolysis. 

On the other hand, although using TXA in long-term prophylaxis in HAE treatment is not recommended, we 

observed that 2 patients had significant reduction of their attack frequency for over a year.