Do Hormonal Disorders Contribute to the Pathology of Hereditary Angioedema?

Abstract

Objective: Hereditary angioedema (HAE) is an autosomal dominant disorder characterized by recurrent episodes of angioedema without urticaria or pruritus. In this study, we compared the levels of anabolic hormones, such as insulin, insulin-like growth factor, growth hormone, and thyroid hormones (thyroid-stimulating hormone [TSH], triiodothyronine [T3], and thyroxine [T4]), and the levels of hormones that are considered catabolic, such as adrenocorticotrophic hormone (ACTH) and cortisol, between HAE patients and controls. We also discuss the contribution of these hormones to the pathophysiology of HAE. Methods: The study included 18 patients (9 diagnosed with HAE type 1 and 9 with HAE type 2) who were followed in the immunology and allergy clinic between January 2013 and January 2020. The control group comprised 28 age- and gender-matched subjects. Results: The HAE type 1, HAE type 2, and control groups showed no significant differences in insulin, insulin-like growth factor, ACTH, cortisol, TSH, or T4 levels. The C-peptide and T3 levels were significantly different between the groups (p = 0.011 and p = 0.027, respectively) (Table 3). Post-hoc pairwise comparison revealed no significant difference in C-peptide level among the groups, but a significant difference in the T3 level was detected between HAE type 1 patients and controls (p = 0.029) Conclusions: Although no significant differences were observed in other anabolic hormone levels between the controls and HAE patients, T3 levels were significantly lower in type 1 HAE patients. Close monitoring of low T3 levels is required, particularly in patients with type 1 HAE.