Reviewer's report
Title:Leukocytosis and high hematocrit levels yield misinterpretation in
abdominal emergency of hereditary angioedema (HAE)
Version: 6Date:20 March 2013
Reviewer: andrea zanichelli
Reviewer's report:
Major Compulsory Revisions
I do agree with authors that it is important to increase awareness of HAE among
physicians and that often this rare condition is misdiagnosed.
Nevertheless the aim of the study is not well defined. This study compare
laboratory findings in HAE patients during remission and during an acute attacks,
does not compare lab tests in patients with HAE during an abdominal attacks and
patients with abdominal pain due to other diseases to explore the cause of
misdiagnosis of HAE.
It is already known that WBC increase during an acute abdominal attack. This
study confirm this data. The increase in WBC does not help in making a
differential diagnosis. Other markers might be helpful ( see manuscript Cugno M
e al, Plasma biomarkers of acute attacks in patients with angioedema due to
C1-inhibitor deficiency, Allergy 2009: 64: 254–257
Minor essential revisions
Keywords:
- C1 inhibitor concentrate
Background:
- “absence or defect of the C1INH”. HAE patients have a deficit of C1 INH. HAE
is an autosomal disease, levels of C1 INH are reduced, <50% of normal
individuals, but C1 INH is present.
- Plasma-derived C1 INH is not the only treatment for acute attacks, there are
several drugs available (Icatibant, Ecallantide, Ricombinat C1 INH). If plasma
derived C1 INh is the only treatment available in Japan the authors have to
specify that this is the situation in Japan
Patients and method:
- authors should report if patients were on prophylactic treatment with androgens
because these drug might increase the hematocrit levels
Results:
- authors should report the value of C3, C4 and functional C1 INH and the normal
range
Conclusions:
- conclusions are unsatisfactory
References:
- authors should include this reference “Cugno M e al, Plasma biomarkers of
acute attacks in patients with angioedema due to C1-inhibitor deficiency, Allergy
2009: 64: 254–257” in place of reference number 6
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Leukocytosis and high hematocrit levels yield misinterpretation in
abdominal emergency of hereditary angioedema (HAE)
Version: 6Date:20 March 2013
Reviewer: andrea zanichelli
Reviewer's report:
Major Compulsory Revisions
I do agree with authors that it is important to increase awareness of HAE among
physicians and that often this rare condition is misdiagnosed.
Nevertheless the aim of the study is not well defined. This study compare
laboratory findings in HAE patients during remission and during an acute attacks,
does not compare lab tests in patients with HAE during an abdominal attacks and
patients with abdominal pain due to other diseases to explore the cause of
misdiagnosis of HAE.
It is already known that WBC increase during an acute abdominal attack. This
study confirm this data. The increase in WBC does not help in making a
differential diagnosis. Other markers might be helpful ( see manuscript Cugno M
e al, Plasma biomarkers of acute attacks in patients with angioedema due to
C1-inhibitor deficiency, Allergy 2009: 64: 254–257
Minor essential revisions
Keywords:
- C1 inhibitor concentrate
Background:
- “absence or defect of the C1INH”. HAE patients have a deficit of C1 INH. HAE
is an autosomal disease, levels of C1 INH are reduced, <50% of normal
individuals, but C1 INH is present.
- Plasma-derived C1 INH is not the only treatment for acute attacks, there are
several drugs available (Icatibant, Ecallantide, Ricombinat C1 INH). If plasma
derived C1 INh is the only treatment available in Japan the authors have to
specify that this is the situation in Japan
Patients and method:
- authors should report if patients were on prophylactic treatment with androgens
because these drug might increase the hematocrit levels
Results:
- authors should report the value of C3, C4 and functional C1 INH and the normal
range
Conclusions:
- conclusions are unsatisfactory
References:
- authors should include this reference “Cugno M e al, Plasma biomarkers of
acute attacks in patients with angioedema due to C1-inhibitor deficiency, Allergy
2009: 64: 254–257” in place of reference number 6
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Leukocytosis and high hematocrit levels yield misinterpretation in
abdominal emergency of hereditary angioedema (HAE)
Version: 6Date:20 March 2013
Reviewer: andrea zanichelli
Reviewer's report:
Major Compulsory Revisions
I do agree with authors that it is important to increase awareness of HAE among
physicians and that often this rare condition is misdiagnosed.
Nevertheless the aim of the study is not well defined. This study compare
laboratory findings in HAE patients during remission and during an acute attacks,
does not compare lab tests in patients with HAE during an abdominal attacks and
patients with abdominal pain due to other diseases to explore the cause of
misdiagnosis of HAE.
It is already known that WBC increase during an acute abdominal attack. This
study confirm this data. The increase in WBC does not help in making a
differential diagnosis. Other markers might be helpful ( see manuscript Cugno M
e al, Plasma biomarkers of acute attacks in patients with angioedema due to
C1-inhibitor deficiency, Allergy 2009: 64: 254–257
Minor essential revisions
Keywords:
- C1 inhibitor concentrate
Background:
- “absence or defect of the C1INH”. HAE patients have a deficit of C1 INH. HAE
is an autosomal disease, levels of C1 INH are reduced, <50% of normal
individuals, but C1 INH is present.
- Plasma-derived C1 INH is not the only treatment for acute attacks, there are
several drugs available (Icatibant, Ecallantide, Ricombinat C1 INH). If plasma
derived C1 INh is the only treatment available in Japan the authors have to
specify that this is the situation in Japan
Patients and method:
- authors should report if patients were on prophylactic treatment with androgens
because these drug might increase the hematocrit levels
Results:
- authors should report the value of C3, C4 and functional C1 INH and the normal
range
Conclusions:
- conclusions are unsatisfactory
References:
- authors should include this reference “Cugno M e al, Plasma biomarkers of
acute attacks in patients with angioedema due to C1-inhibitor deficiency, Allergy
2009: 64: 254–257” in place of reference number 6
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
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