Case Study Angioedema

Nicole is a 35-year-old mentally handicapped young woman. All of her life she has complained of her stomach hurting. The stomach pain would occur a couple of times a week. As she got older the weekly stomach complaints became a daily complaint. In addition to this problem, as a pre-teen, around eleven years old, she started to experience swelling of her hands and feet with no none cause. The swelling would start on one hand and the gradually affected her other hand, then each foot, or visa-versa. A rash would always appear on her body during the angioedema episodes. A rash would sometimes appear on her arms, but it also would occur in other areas. The only common factor that her family observed was that the angioedema always seemed to follow
Patients can go many years without a diagnoses. It is usually misdiagnosed as some type of urticarial event. Because the patient experiences angioedema in different areas it can it can lead to unnecessary medical procedures or even unnecessary surgery. Especially the patients whom struggle with stomach pain. Some patients are sent for psychiatric evaluation due to doctors believing that the disorder is just their imagination. Laboratory tests are needed to identify the presence of the hereditary angioedema. Gauging the C4 levels is a low cost measurement that can be performed to rule out hereditary
It is because of an alteration that resulted in shortened or misfolded C1 inhibitor proteins. It is also in the category of having low C1 and C4 levels. Type II HAE patients have an alteration that causes the C1 inhibitor to be defective: IE: not working to its full potential. Their C4 levels will also be low.
Treatments Available

In conclusion Nicole is one of the lucky patients in that she was finally diagnosed at the age of 21. Due to her parents being proactive in searching for an answer to her swelling and stomach problems

References

Zuraw, B. L., M.D. (2008). Hereditary angioedema. The New England Journal of Medicine, 359(10), 1027-36. doi:http://dx.doi.org/10.1056/NEJMcp0803977
Wade, J., & Barkley, T. W. (2015). Hereditary angioedema: An emergency nursing perspective. Journal of Emergency Nursing, 41(5), 391-395. doi:http://dx.doi.org/10.1016/j.jen.2015.02.001
Jack B, M. D., F.A.C.S. (2011). Hereditary angioedema: A clinical review for the otolaryngologist. Ear, Nose & Throat Journal, 90(1), 32-9. Retrieved from http://stacks.tridenttech.edu:2048/login?url=http://search.proquest.com/docview/849519080?accountid=14400

After many trips to the doctor, and countless allergy testing, the only medicine in the early years that seemed to help was high doses of the steroid