To the Editor.
—In a recent article in JAMA, the guidelines for the use of fresh-frozen plasma were reviewed.1 Although many clinical indications were listed, most for the treatment of coagulopathies, an important omission was made. Not mentioned was the prophylactic use of fresh-frozen plasma in patients with hereditary angioedema before oral surgery. Patients with hereditary angioedema are prone to acute, severe attacks of upper airway edema. Dental procedures are a well-recognized precipitating factor. Prophylaxis with fresh-frozen plasma prior to oral surgery is effective in preventing attacks of angioedema.2 Therefore, the clinical indications for the use of fresh-frozen plasma should include patients with hereditary angioedema.
Lieberman A. The Use of Fresh-Frozen Plasma in Hereditary Angioedema. JAMA. 1994;272(7):518. doi:10.1001/jama.1994.03520070036029