Hereditary angioedema

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Definition

  • Congenital defect in C1 inhibitor (or C1 esterase inhibitor) causing recurrent episodes of angioedema potentially involving any mucosal surface

Classification

  • Type I: abnormally low levels of normal serum C1 inhibitor
  • Type II: normal levels of abnormal serum C1 inhibitor
  • Type III: increased kininogenase activity (C1 inhibitor is normal)

Epidemiology

  • 25% of cases are caused by do novo mutations

Clinical Presentation

  • Recurrent episodes of angioedema (can involve any mucosal surface) without urticaria or pruritis
  • May have a family history

Investigations

  • Screening bloodwork in suspected cases:
    • Complement component 4 (C4), which may be low
    • C1 inhibitor (C1INH) antigenic levels
    • C1INH functional levels

Management

  • Acute
  • Chronic

Further Reading