Patient-reported Premonitory Signs And Symptoms (Prodromes) May Predict Attacks Of Hereditary Angioedema | 32467
Journal of Nursing & Care
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Patient-reported premonitory signs and symptoms (Prodromes) may predict attacks of Hereditary Angioedema
3rd Euro Nursing & Medicare Summit
Iris Leibovich1.2, Hava Golander2, Raz Somech3 and Avner Reshef1
1Allergy, Immunology & Angioedema Center, Sheba Medical Center, Tel- Hashomer
2Department of Nursing, Sackler School of Medicine
3Safra Pediatric Hospital, Tel-Hashomer. All affiliated to the University of Tel Aviv, Israel
Background: Premonitory symptoms (prodromes) are reported by a large majority of patients with hereditary angioedema
(HAE). They include subjective and objective signs and symptoms and may precede the attacks by many hours. Previous
studies show that prodromes are more frequent than previously assumed and might be overlooked by caretakers and
specialists. They might provide important clues for the understanding of patients' illness trajectory and may help in early
detection and interventions that may improve the outcome of HAE attacks. This preliminary study was aimed at understanding
the association between prodromes and attacks by comparing similar dimensions (i.e. formation, location, severity, duration,
organ dysfunction etc.)
Methods: We report the results of a preliminary study of 15 HAE patients (6 men, 9 women, mean age 26.6 years, range 9-47).
A specific questionnaire was constructed and refined, based on previous instruments used by our group and others. Data
was obtained on the disease course and its burden on daily life, patients' experience with prodromes and whether they can
predict an incoming attack based on such symptoms. The questions included either categorical parameters (yes/no) or nominal
(duration, incidence etc.).
Results: Most patients could identify and locate the various dimensions of the prodromes and differentiate them from the
attacks. Prodrome dimensions were correlated to the attack in most organ clusters. Internal consistency (alpha Cronbach) of
the various components of the questionnaires was high.
Conclusions: Prodromes are frequently reported by HAE patients and there is an association between them and attack severity,
location and dysfunction.
Iris Leibovich-Nassi Graduate of Beilinson Nursing School, Israel (1982) with rich professional career in Nephrology, Ophthalmology, Gynecology and Allergy/ Immunology. Currently a senior nurse and study coordinator at the Angioedema Center, Sheba Medical Center affiliated to Sackler School of Medicine, Tel Aviv University. Past chair woman of the Israeli Allergy and Immunology Nursing Association. Presently member of the steering committee of the International HAE Nursing Association. She has Master's Degree in nursing and working on her PhD thesis, focusing on the premonitory signs and symptoms of Hereditary Angioedema (HAE) attacks ("Prodromes"). She is consulting to HAE patients in self-management, family matters and quality of life issues.