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2014, Number 5

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Cir Cir 2014; 82 (5)

Hereditary angioedema: strange cause of abdominal pain

Salas-Lozano NG, Meza-Cardona J, González-Fernández C, Pineda-Figueroa L, de Ariño-Suárez M
Full text How to cite this article

Language: Spanish
References: 7
Page: 563-566
PDF size: 585.80 Kb.


Key words:

Hereditary angioedema, abdominal pain, complement C1 inhibitor, autosomal dominant.

ABSTRACT

Background: Hereditary angioedema is an episodic swelling disorder with autosomal dominant inheritance characterized by sudden attacks of peripheral swelling. Patients also commonly have episodic swelling of the wall of hollow viscera, including the bowel.
Clinical case: We present a 33-year-old previously healthy male with a complaint of acute-onset intense abdominal pain localized in the epigastrium. Pain irradiated to the right lower quadrant and was associated with five episodes of vomiting. Computed tomography showed thickening of the duodenal wall with liquid in the subphrenic space. Complementary laboratory tests showed low C4 complement levels (5.5 mg/dl) and 30% complement C1 inhibitor activity.
Conclusions: Hereditary angioedema is caused by a deficiency (type I) or dysfunction (type II) in complement C1 inhibitor. Abdominal pain associated with angioedema may manifest as severe acute-onset abdominal pain or as moderately severe chronic recurrent abdominal pain. Two medications are currently FDA-approved for the treatment of these patients.


REFERENCES

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  2. Al Awad A, Galban JT, Ocando M, Loero A, Molero F. Angioedema hereditario: causa rara de dolor abdominal. Cir Esp 2012;90:261-272.

  3. Frank MM. Hereditary angioedema. J Allergy Clin Immunol 2008;121(2):S398-S401.

  4. Nzeako UC, Frigas E, Tremaine WJ. Hereditary Angioedema. A Broad Review for Clinicians. Arch Intern Med 2001;161(20):2417-2429.

  5. Gompels MM, Lock RJ, Abinun M, Bethune CA, Davies G, Grattan C, et al. C1 inhibitor deficiency: consensus document. Clin Exp Immunol 2005;139(3):379-394.

  6. Nzeako U. Diagnosis and management of angioedema with abdominal involvement: A gastroenterology perspective. World J Gastroenterol 2010;16(39):4913-4921.

  7. Zuraw BL. Hereditary Angioedema. N Engl J Med 2008;359:1027-1036.




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Cir Cir. 2014;82