The Hereditary Angioedema Unit (UAEH) of Vall d’Hebron University Hospital’s Allergology Department has been treating patients with this disorder for more than 25 years.

UAEH outpatients are treated by allergology specialists in a multidisciplinary manner in the Outpatient Clinic in the Old Nursing School and in the Children’s and Women’s Hospital, ensuring transference and continuity of care from childhood through to adulthood for this genetic, lifelong condition.

The Unit is made up of popular, immunologists, geneticists, gynaecologists, maxillofacial surgeons, pharmacists and nurses, who are responsible for:

• diagnosing and monitoring patients
• conducting immunological and genetic studies
• providing health education to ensure that patients are capable of recognising angioedema episodes and self-administering their treatment
• treating patients in special situations such as pregnancy, delivery, the postpartum period and during complex dental procedures.

Depending on the type of care to be given to patients with diagnosed hereditary angioedema and their profile, they should be treated by the following divisions and/or units:

 

Allergology Outpatient Clinic and Day Hospital

The specialists who work in the adult and paediatric allergology sections are responsible for treating patients aged 16 and under in the Children’s Hospital areas and subsequently facilitating their transfer and continuity of care with monitoring to the adult care departments in the Old Nursing School and the Allergology Day Hospital in the General Hospital.

The Hereditary Angioedema Unit (UAEH) offers an outpatient service to monitor patients with this disease: the Outpatient Clinic on the second floor of the Old Nursing School. Also, as it is a multidisciplinary unit, and depending on the type of patient (child, adult, pregnant woman), it provides care in a number of departments and units in the Children’s and Women’s Hospital, the General Hospital and A&E.

The nursing team specialises in education and specific care for patients with this disease.

 

A&E Care

Emergency care is provided at the Children’s Hospital for patients up to the age of 16 and at the General Hospital from the age of 17. The professionals who work in the A&Es have been trained to recognise the symptoms of this disease and to quickly provide its specific treatment.

 

Maxillofacial Surgery Outpatient Clinic

When a patient needs a complex dental or maxillofacial procedure they will be assessed by the hospital’s maxillofacial surgeons and their operation will be organised with the suitable prophylaxis.

 

Patients who have hereditary angioedema and who are pregnant

The Obstetrics, Foetal Medicine and Anaesthesia Departments have created a Working Unit for High-Risk Pregnancies for women with hereditary angioedema with the aim of monitoring the well-being of mother and child during pregnancy and of providing care during the delivery and postpartum period in accordance with a protocol specific to their type of hereditary angioedema and clinical situation. Care is also provided for high-risk postpartum cases.

In parallel to these services, there is also a reproductive counselling clinic for women with hereditary angioedema. The clinic is part of the Hereditary Angioedema Unit, and is that provided in conjunction with Gynaecology in the Outpatient Clinics of the Children’s and Women’s Hospital.

In this clinic an allergist and a gynaecologist combine their expertise to determine, in accordance with the patient’s clinical situation and type of hereditary angioedema, the possible effects of their having children. Their mission is to provide information and advice in relation to family planning and the reproductive possibilities of the patients living with this disease.

In our Unit, we treat infants with infections and immunodeficiencies, a pathology that has become increasingly important in recent years. This increase in cases is due to several reasons, such as the emergence of AIDS, the emergence of almost forgotten pathogens, the importing of diseases from other geographical areas, the increase in opportunistic infections as a consequence of more aggressive treatments and more invasive diagnostic techniques, and the presence of new patterns of microbial resistance. This is in addition to the significant differences between treating children and adults. For this reason, our discipline is constantly being reviewed and updated, and is a key specialty for all hospital centres.

Our Unit was created in January 1996, as a hospitalisation unit dedicated to the study and treatment of paediatric illnesses of infectious origin, and in June 2004 it also incorporated the day hospital and the Outpatient Clinic for HIV and Primary Immunodeficiencies. A year later, at the initiative of the centre's management, it consolidated itself as a modern infectology unit, taking over consultation functions in the diagnosis and control of complex infection of critical and immunodepressed patients as well as patients from various paediatric specialties. We went on to incorporate the Outpatient Clinic for Infectious Community Diseases (contracted outside the hospital), Vertical Transmission Infections (from mother to child) and Pathologies, such as tropical diseases.

 

Portfolio of services

• Infectious pathology consultation service for healthy immunosuppressed children

• Hospitalisation for infectious pathologies and immunodeficiencies

• Genetic counselling and risk assessment for immunodeficiencies

• HIV Outpatient Clinic

• Vertical Transmission Infections Outpatient Clinic

• Community Infectious Diseases Outpatient Clinic

• Primary Immunodeficiencies Outpatient Clinic

• Imported Illnesses Outpatient Clinic

• High resolution clinic

• Second opinion Clinic

• Interhospital Clinic

• Digital Clinic

• “I’m not alone” programme

• Specialised psychosocial care

 

Teaching

• Undergraduate training at the Autonomous University of Barcelona (UAB)

• Training programme for residents

• Monthly teaching sessions with ten hospital centres, using telemedicine

• Bi-weekly clinical sessions: Tuesday, at 3:00 p.m.; Thursday, at 8:15 a.m.

• Annual continuing education courses: paediatric infectology course and national IFI course

• Master's in paediatric infectology by the UAB.

• Protocols and sessions

 

Research

The Unit participates in multiple studies and clinical trials, leading many of them. It is also home to the Infections in the immunocompromised paediatric patient research group. The main research lines of the Unit are:

• Safety, efficacy and tolerance of anti-infectious agents

• Family epidemiologic study of primary immunodifficiencies

• Vertical transmission of HIV, Chagas and HTLV

• Evolution of C/N infection by gram-positive cocci and "Candida"

• Hidden hepatitis B virus (HBV) infection in immunocompromised patients

• Hospitalisation risk factors for influenza A (H1N1)