AUTHOR=Cancian Mauro , Triggianese Paola , Modica Stella , Arcoleo Francesco , Bignardi Donatella , Brussino Luisa , Colangelo Caterina , Di Agosta Ester , Firinu Davide , Guarino Maria Domenica , Giardino Francesco , Giliberti Marica , Montinaro Vincenzo , Senter Riccardo 

TITLE=The impact of puberty on the onset, frequency, location, and severity of attacks in hereditary angioedema due to C1-inhibitor deficiency: A survey from the Italian Network for Hereditary and Acquired Angioedema (ITACA)

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2023.1141073

DOI=10.3389/fped.2023.1141073

ISSN=2296-2360

ABSTRACT=Hereditary angioedema due to C1-inhibitor deficiency is influenced by hormonal factors, with a more severe course of disease in women. Our study aims to deepen the impact of puberty on onset, frequency, location and severity of attacks. 
Retrospective data were collected through a semi-structured questionnaire and shared by 10 Italian reference centers of the Italian Network for Hereditary and Acquired Angioedema (ITACA).
The proportion of symptomatic patients increased significantly after puberty (98.2% vs 83.9%, p=0.002 in males; 96.3% vs 68,4%, p<0,001 in females); the monthly mean of acute attacks was significantly higher after puberty, and this occurred both in females (median (IQR) = 0,41(2) in the three years before puberty vs 2(2,17) in the three years after,  p<0,001) and in males (1(1,92) vs 1,25(1,56) respectively, p<0,001). The increase was greater in females. No significant differences were detected in attack location before and after puberty.