Skooter reporting 10/20/12
A woman’s struggle to find a diagnosis after struggling with severe facial swelling was highlighted in a report in the New England Journal of Medicine.
The case was about a 54-year-old woman who came to a clinic with “progressive swelling” of her face, Dr. Didier G. Ebo and Chris H. Bridts from the University of Antwerp in Belgium wrote. In two to six hours of an occurrence, the woman’s face would swell to the point where her lips become puffy and her face twisted.
Shortness of breath in the patient was absent, though starting in her early 30s, she had a nearly 10-year history of swelling of the tongue, larynx, trunk and other extremities.
Despite taking an antihistamine or steroids, her episodes would last from hours to three days, the woman told doctors.
Doctors uncertainly diagnosed her with type III hereditary angioedema. According to the U.S. National Library of Medicine it is a rare, but serious problem with the immune system that causes swelling of the face. The disease is caused by low levels of a protein known as C1 inhibitor, but since the woman’s C1 levels were all right, she was diagnosed with type III.
It is believed that type III hereditary angioedema is the reason for the build-up of the peptide bradykinn, which can occur when a person is taking ACE-inhibitors, however, doctors observed this woman was not.
The woman was administered with transexamic acid, a medicine used to treat heavy bleeding during menstrual periods as maintenance therapy. She was told not take any treatment for hypertension such as ACE inhibitors or angiotensin-receptor blockers.
Following a three-year follow-up, the woman said her occurrences were less severe and happened less oftenly.