Dr. Ungureanu Gabriela

Dr. Ungureanu Gabriela
Spitalul Judeţean de Urgenţe Bacău

Urticaria cronică spontană – Prezentare de caz
Autor: Gabriela Ungureanu

Sef sectie dermatogie-alergologie – Spitalul judetean de urgenta Bacau

Angioedemul ereditar este o boala genetica rara, cu transmitere autosomal dominanta, cauzata de un deficit de C1 inhibitor esteraza, prin mutatia genei SERPING1 ,caracterizata clinic prin episoade recurente de angioedem subcutanat sau submucos ce implica extremitatile, fata, caile aeriene respiratorii superioare si tractul gastro-intestinal.
Fiziopatologic deficitul de C1 inhibitor esteraza serologic sau functional duce la cresterea productiei de bradikinina ceea ce duce la cresterea permeabilitati vasculare cu aparitia angioedemului.
Cel mai grav este angioedemul laringeal cu potential fatal prin asfixie si care necesita terapie imediata.
Diagnosticul corect si promt este esential la pacientul cu angioedem ereditar care nu raspunde la medicatia antihistaminica si corticoterapia sistemica tipic utilizata in angioedemul mediat histaminergic. Intarzierea diagnosticului poate fi amenintatoare de viata la pacientul cu angioedem laringeal.
Accesul facil la medicul specialist si terapiile eficente din ultimi 10 ani au imbunatatit calitatea vietii pacientului cu angioedem ereditar si au redus rata mortalitati acestor pacienti.
Scopul terapiei in atacurile acute, ca si profilaxia pe termen lung, este de a reduce frecventa si severitatea atacurilor prin monitorizare, terapie si administre de catre pacienti la domiciliu a concentratelor de C1 inhibitori.

Hereditary angioedema update and case report 
Author: Gabriela Ungureanu

Senior Physician in Allergology and clinical Immunology
Head of the Department of Dermatology and Allergology, Emergency Hospital Bacau

Hereditary angioedema is a rare genetic disorder – autosomal dominant caused by C1 esterase inhibitor – C1INH deficiency and it’s characterized by recurrent episodes of severe swelling which involves the face, limbs, airways or gastro-intestinal tract.
Deficiencies in C1INH plasma level or function lead to increased production of bradykinin, which mediates vascular permeability, thus causing angioedema.
Laryngeal oedema is potentially life-threatening as a result of asphyxiation and requires immediate treatment.
Prompt and accurate diagnosis is essential as patients with hereditary angioedema do not respond to drugs typically prescribed for histaminergic mediated angeoedema. Delays in diagnosis can be fatal, particularly in the case of laryngeal oedema.
Hereditary angioedema therapy aims to avoid fatalities and to reduce the frequency and severity of angioedema attacks by means of on demand and short – and long – term prophilactic treatment. Acute treatment option includes C1INH concentrate (icatibant or ecallantide) administratied on site or self administratied at home when swelling appears.
Acces to specialist care and effective treatment in the past 10 years has improved the quality of life and has reduced the mortality rate in patients with hereditary angioedema.

Scurt CV

Experiența:
2014 – Prezent – Manager clinica ”New Medical” Bacău – Clinica alergologie–imunologie clinică
2004 – Prezent – Coordonator compartiment alergologie–imunologie clinică, Secția dermato–venerice , Spitalul Judeţean de Urgenţe Bacău
2019 – Specialist dermato–venerice
2009 – Medic primar alergologie imunologie clinică
2004 – Medic specialist alergologie imunologie clinică
1999 – 2004 – Rezident alergologie imunologie clinică Spital Clinic “Nicolae Malaxa” București, U.M.F. “Carol Davila”
1996 – 1999 – Serviciu de Ambulanță Județean Bacău
1990 – 1996 – U.M.F. “Grigore T. Popa“ Iași – Medic Generalist

Apartenenţa la Societăţi ştiinţifice:
Membru Societatea Română Dermatologie
Membru Societatea Română de Alergologie Imunologie Clinică
Membru Academia Europeană de Alergologie Imunologie Clinică
Membru Asociația Dermatologilor din Moldova