Severe postoperative wound healing disturbance in a patient with alpha‐1‐antitrypsin deficiency: the impact of augmentation therapy
Identifieur interne : 002367 ( Istex/Corpus ); précédent : 002366; suivant : 002368Severe postoperative wound healing disturbance in a patient with alpha‐1‐antitrypsin deficiency: the impact of augmentation therapy
Auteurs : Marionna Cathomas ; Alexandra Schüller ; Daniel Candinas ; Roman InglinSource :
- International Wound Journal [ 1742-4801 ] ; 2015-10.
Abstract
Wound healing disturbance is a common complication following surgery, but the underlying cause sometimes remains elusive. A 50‐year‐old Caucasian male developed an initially misunderstood severe wound healing disturbance following colon and abdominal wall surgery. An untreated alpha‐1‐antitrypsin (AAT) deficiency in the patient's medical history, known since 20 years and clinically apparent as a mild to moderate chronic obstructive pulmonary disease, was eventually found to be at its origin. Further clinical work‐up showed AAT serum levels below 30% of the lower reference value; phenotype testing showed a ZZ phenotype and a biopsy taken from the wound area showed the characteristic, disease‐related histological pattern of necrotising panniculitits. Augmentation therapy with plasma AAT was initiated and within a few weeks, rapid and adequate would healing was observed. AAT deficiency is an uncommon but clinically significant, possible cause of wound healing disturbances. An augmentation therapy ought to be considered in affected patients during the perioperative period.
Url:
DOI: 10.1111/iwj.12419
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ISTEX:C21189B2D72B80867F154C25EFC27CC2B46E13D6Le document en format XML
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A 50‐year‐old Caucasian male developed an initially misunderstood severe wound healing disturbance following colon and abdominal wall surgery. An untreated alpha‐1‐antitrypsin (AAT) deficiency in the patient's medical history, known since 20 years and clinically apparent as a mild to moderate chronic obstructive pulmonary disease, was eventually found to be at its origin. Further clinical work‐up showed AAT serum levels below 30% of the lower reference value; phenotype testing showed a ZZ phenotype and a biopsy taken from the wound area showed the characteristic, disease‐related histological pattern of necrotising panniculitits. Augmentation therapy with plasma AAT was initiated and within a few weeks, rapid and adequate would healing was observed. AAT deficiency is an uncommon but clinically significant, possible cause of wound healing disturbances. 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Cathomas <fi>et al.</fi></title></titleGroup><creators><creator creatorRole="author" xml:id="iwj12419-cr-0001" affiliationRef="#iwj12419-aff-0001"><personName><givenNames>Marionna</givenNames>
<familyName>Cathomas</familyName></personName></creator><creator creatorRole="author" xml:id="iwj12419-cr-0002" affiliationRef="#iwj12419-aff-0001"><personName><givenNames>Alexandra</givenNames>
<familyName>Schüller</familyName></personName></creator><creator creatorRole="author" xml:id="iwj12419-cr-0003" affiliationRef="#iwj12419-aff-0001"><personName><givenNames>Daniel</givenNames>
<familyName>Candinas</familyName></personName></creator><creator creatorRole="author" xml:id="iwj12419-cr-0004" affiliationRef="#iwj12419-aff-0001" corresponding="yes"><personName><givenNames>Roman</givenNames>
<familyName>Inglin</familyName></personName></creator></creators><affiliationGroup xml:id="iwj12419-affgp-0001"><affiliation countryCode="CH" type="organization" xml:id="iwj12419-aff-0001"><orgDiv>Department of Visceral Surgery and Medicine</orgDiv><orgName>University Hospital of Bern</orgName><address><city>Bern</city><country>Switzerland</country></address></affiliation></affiliationGroup><keywordGroup type="author"><keyword xml:id="iwj12419-kwd-0001">Alpha‐1‐antitrypsin deficiency</keyword><keyword xml:id="iwj12419-kwd-0002">Laparotomy</keyword><keyword xml:id="iwj12419-kwd-0003">Panniculitis</keyword><keyword xml:id="iwj12419-kwd-0004">Postoperative</keyword><keyword xml:id="iwj12419-kwd-0005">Surgery</keyword><keyword xml:id="iwj12419-kwd-0006">Wound healing disturbance</keyword></keywordGroup><abstractGroup><abstract type="main" xml:id="iwj12419-abs-0001"><title type="main">Abstract</title><p xml:id="iwj12419-para-0001">Wound healing disturbance is a common complication following surgery, but the underlying cause sometimes remains elusive. A 50‐year‐old Caucasian male developed an initially misunderstood severe wound healing disturbance following colon and abdominal wall surgery. An untreated alpha‐1‐antitrypsin (AAT) deficiency in the patient's medical history, known since 20 years and clinically apparent as a mild to moderate chronic obstructive pulmonary disease, was eventually found to be at its origin. Further clinical work‐up showed AAT serum levels below 30% of the lower reference value; phenotype testing showed a <fc>ZZ</fc> phenotype and a biopsy taken from the wound area showed the characteristic, disease‐related histological pattern of necrotising panniculitits. Augmentation therapy with plasma AAT was initiated and within a few weeks, rapid and adequate would healing was observed. AAT deficiency is an uncommon but clinically significant, possible cause of wound healing disturbances. An augmentation therapy ought to be considered in affected patients during the perioperative period.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Severe postoperative wound healing disturbance in a patient with alpha‐1‐antitrypsin deficiency: the impact of augmentation therapy</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Wound healing disturbance in a patient with alpha‐1‐antitrypsin deficiency</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Severe postoperative wound healing disturbance in a patient with alpha‐1‐antitrypsin deficiency: the impact of augmentation therapy</title></titleInfo><name type="personal"><namePart type="given">Marionna</namePart><namePart type="family">Cathomas</namePart><affiliation>Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alexandra</namePart><namePart type="family">Schüller</namePart><affiliation>Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Daniel</namePart><namePart type="family">Candinas</namePart><affiliation>Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Roman</namePart><namePart type="family">Inglin</namePart><affiliation>Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland</affiliation><affiliation>Dr. R Inglin, MDDepartment of Visceral Surgery and MedicineBern University HospitalFreiburgstrasse 10CH‐3010 BernSwitzerlandE‐mail:</affiliation><affiliation>E-mail: roman.inglin@insel.ch</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="case-report" displayLabel="caseStudy" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-29919SZJ-6">case-report</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2015-10</dateIssued><dateCreated encoding="w3cdtf">2015-02-09</dateCreated><dateCaptured encoding="w3cdtf">2014-10-03</dateCaptured><dateValid encoding="w3cdtf">2014-12-23</dateValid><copyrightDate encoding="w3cdtf">2015</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract>Wound healing disturbance is a common complication following surgery, but the underlying cause sometimes remains elusive. A 50‐year‐old Caucasian male developed an initially misunderstood severe wound healing disturbance following colon and abdominal wall surgery. An untreated alpha‐1‐antitrypsin (AAT) deficiency in the patient's medical history, known since 20 years and clinically apparent as a mild to moderate chronic obstructive pulmonary disease, was eventually found to be at its origin. Further clinical work‐up showed AAT serum levels below 30% of the lower reference value; phenotype testing showed a ZZ phenotype and a biopsy taken from the wound area showed the characteristic, disease‐related histological pattern of necrotising panniculitits. Augmentation therapy with plasma AAT was initiated and within a few weeks, rapid and adequate would healing was observed. AAT deficiency is an uncommon but clinically significant, possible cause of wound healing disturbances. An augmentation therapy ought to be considered in affected patients during the perioperative period.</abstract><subject><genre>keywords</genre><topic>Alpha‐1‐antitrypsin deficiency</topic><topic>Laparotomy</topic><topic>Panniculitis</topic><topic>Postoperative</topic><topic>Surgery</topic><topic>Wound healing disturbance</topic></subject><relatedItem type="host"><titleInfo><title>International Wound Journal</title></titleInfo><titleInfo type="abbreviated"><title>Int Wound J</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>article-category</genre><topic>CASE REPORT</topic><topic>CASE REPORTS</topic></subject><identifier type="ISSN">1742-4801</identifier><identifier type="eISSN">1742-481X</identifier><identifier type="DOI">10.1111/(ISSN)1742-481X</identifier><identifier type="PublisherID">IWJ</identifier><part><date>2015</date><detail type="volume"><caption>vol.</caption><number>12</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>601</start><end>604</end><total>4</total></extent></part></relatedItem><relatedItem type="references" displayLabel="iwj12419-cit-0001"><titleInfo><title>Factors affecting wound healing</title></titleInfo><name type="personal"><namePart type="given">S</namePart><namePart type="family">Guo</namePart><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">LA</namePart><namePart type="family">Dipietro</namePart><role><roleTerm type="text">author</roleTerm></role></name><genre>journal-article</genre><note type="citation/reference">Guo S, Dipietro LA. 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