Evidence map›Paper›PMID 33643518›Full record

ArticleThe World Allergy Organization journal2021

Survey of actual conditions of erythema marginatum as a prodromal symptom in Japanese patients with hereditary angioedema.

Isao Ohsawa, Atsushi Fukunaga, Shinya Imamura, Kazumasa Iwamoto, Akio Tanaka, Michihiro Hide, Daisuke Honda, Kouhei Yamashita, Chisako Fujiwara, Osamu Ishikawa and 7 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The World Allergy Organization journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. National survey on clinical and genetic characteristics of patients with hereditary angioedema in Latvia.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2023
    Article
  5. Urticaria and mimickers of urticaria.Frontiers in allergy · 2023
    Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 11 institutions in 1 country.

Isao OhsawaDepartment of Nephrology, Internal Medicine, Saiyu Soka Hospital, Soka City, Saitama, Japan.
Atsushi FukunagaDivision of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Shinya ImamuraDivision of Dermatology, Department of Internal Related, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Kazumasa IwamotoDepartment of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan.
Akio TanakaDepartment of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan.
Michihiro HideDepartment of Dermatology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan.
Daisuke HondaDepartment of Nephrology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan.
Kouhei YamashitaDepartment of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan.
Chisako FujiwaraDepartment of Dermatology, Gunma University Graduate School of Medicine, Maebashi City, Gunma, Japan.
Osamu IshikawaDepartment of Dermatology, Gunma University Graduate School of Medicine, Maebashi City, Gunma, Japan.
Takeo YamaguchiDepartment of Gastroenterology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya City, Nagoya, Japan.
Junichi MaeharaDepartment of Acute Care and General Medicine, Saiseikai Kumamoto Hospital, Kumamoto City, Kumamoto Japan.
Tomoya HiroseDepartment of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita City, Osaka Japan.
Masahiro IekoDepartment of Internal Medicine, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan.
Kunihiko UmekitaDepartment of Rheumatology, Infectious Diseases and Laboratory Medicine, University of Miyazaki, Miyazaki City, Miyazaki, Japan.
Yuya NakamuraDepartment of Nephrology, Internal Medicine, Saiyu Soka Hospital, Soka City, Saitama, Japan.
Hiromichi GotohDepartment of Nephrology, Internal Medicine, Saiyu Soka Hospital, Soka City, Saitama, Japan.
Hiroshima University · JPSoka Municipal Hospital · JPGunma University · JPKobe University · JPHealth Sciences University of Hokkaido · JPJapanese Red Cross Nagoya Daiichi Hospital · JPJuntendo University · JPKyoto University · JPOsaka Police Hospital · JPSaiseikai Kumamoto Hospital · JPUniversity of Miyazaki · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHereditary angioedema (HAE) is a rare but life-threatening condition. HAE types I and II (HAE-1/2) result from C1-inhibitor (C1-INH) deficiency. However, recent genetic analysis has established a new type of HAE with normal C1-INH (HAEnC1-INH). The mutations of factor XII, plasminogen, angiopoietin 1, and kininogen 1 genes may be the cause of HAEnC1-INH. Nevertheless, other causative molecules (HAE-unknown) may be involved. The Japanese therapeutic environment for HAE has been improving owing to the self-subcutaneous injection of icatibant, which was approved for the treatment of acute attack and enables early therapy. Erythema marginatum (EM) is a visible prodromal symptom which occasionally occurs prior to an angioedema attack; hence, recognizing the risk of an acute attack is important for early treatment. However, the detailed characteristics of EM remain unclear. In this study, we first investigated the clinical manifestations of EM in Japanese patients with HAE.

methodsA 20-point survey was developed and distributed to 40 physicians to gather clinical data on EM from patients with HAE.

resultsData on 68 patients with HAE (58 patients with HAE-1/2 and 10 patients with HAE-unknown) were collected. Of the patients with HAE-1/2, 53.4% experienced EM, whereas 43.1% did not. The forearm was the most frequent area of EM (64.5%), followed by the abdomen (29.0%) and upper arm and precordium (19.3%). Of the HAE-1/2 patients with EM, 41.9% always had angioedema following EM, while 29.0% always had colocalization of EM with angioedema. Moreover, 3.2% showed a correlation between the awareness of EM and severity of an angioedema attack. In 60.9% of HAE-1/2 patients with EM, the interval between the awareness of EM and appearance of angioedema was <3 h. Of the patients with HAE-unknown, 30.0% also experienced EM.

conclusionWe confirmed that more than one-half of Japanese patients with HAE-1/2 and one-third of those with HAE-unknown develop EM as the prodromal symptom of an angioedema attack. Physicians should communicate the significance of EM to patients with HAE to prepare them for possible imminent attacks.

Indexed as

ANGPT1, angiopoietin 1BKB2-A, bradykinin-B2-receptor antagonistBradykininC1–INH, C1-inhibitorC1-inhibitorEM, erythema marginatumErythema marginatumF12, factor XIIHAE-1/2, HAE types I and IIHAE, hereditary angioedemaHAEnC1-INH, HAE with normal C1-inhibi torHereditary angioedemaIcatibantKNG1, kininogen 1pdC1-INH, plasma derived- C1INHPLG, plasminogenProdromal symptomSERPING1, serpin family G member 1

Identifiers

PMID33643518
PMCPMC7872976
OpenAlexW3126963957

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.