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Headache and complement C'1-esterase inhibitor deficiency in Vietnamese immigrants living in southern California

K V Luong, L T Nguyen

    Allergy and Asthma Proceedings
    |April 21, 1999
    PubMed

    Insights

    Vietnamese headache patients showed low complement C'1-esterase inhibitor (C1INH) levels. Treatment with danazol normalized C1INH and improved headaches, suggesting an androgen-responsive headache type.

    Area of Science:

    • Immunology
    • Neurology

    Background:

    • Headache disorders, including migraine and chronic tension-type headache, affect a significant portion of the population.
    • The complement system plays a role in inflammatory processes, and its components may be implicated in headache pathophysiology.
    • Complement C'1-esterase inhibitor (C1INH) is a key regulator of the complement cascade.

    Purpose of the Study:

    • To measure C1INH levels in Vietnamese outpatients diagnosed with migraine or chronic tension-type headache.
    • To investigate the effect of danazol treatment on C1INH levels and headache symptoms.
    • To differentiate this patient group from hereditary or acquired angioedema.

    Main Methods:

    • Fifty-one Vietnamese outpatients with headache (migraine or chronic tension-type) were evaluated.
    • C1INH levels were measured and compared to control subjects.
    • A subset of 20 patients received danazol (200 mg daily) for 1-2 months, with subsequent C1INH and C1q/C4d measurements.

    Main Results:

    • Patients exhibited significantly lower C1INH levels (11 +/- 2 mg/dL) compared to controls (15 +/- 2 mg/dL, p < 0.0001).
    • Danazol treatment normalized C1INH levels (16 +/- 2 mg/dL, p < 0.001) and coincided with headache improvement.
    • C1q and C4d/C4 ratios remained unchanged after danazol treatment.

    Conclusions:

    • The findings suggest a potential form of androgen-responsive headache associated with low C1INH levels.
    • This condition appears distinct from hereditary or acquired angioedema, lacking typical precipitating factors or family history.
    • C1INH levels may serve as a biomarker for a specific headache subtype responsive to androgen therapy.

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