SIGURDUR E. THORVALDSSON, M.D.; RICHARD E. SEDLACK, M.D.; GERALD J. GLEICH, M.D.; SHAUN J. RUDDY, M.D.
Angioneurotic edema and symptoms of intestinal obstruction developed in a woman when she was 58 years old. Surgical exploration during an attack of abdominal pain showed a segment of jejunum that was edematous and thickened and had a narrowed lumen. Analysis of the patient's serum showed a reduction in C′4 activity and a marked deficiency of C′1 esterase inhibitor, the biochemical hallmarks of hereditary angioneurotic edema. There was no family history of angioneurotic edema. The patient later died from an attack of laryngeal edema. This case illustrates the need for analysis of serum for this deficiency in elderly patients with angioneurotic edema and abdominal pain even though the family history is negative.
THORVALDSSON SE, SEDLACK RE, GLEICH GJ, et al. Angioneurotic Edema and Deficiency of C′1 Esterase Inhibitor in a 61-Year-Old Woman. Ann Intern Med. 1969;71:353–357. doi: 10.7326/0003-4819-71-2-353
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Published: Ann Intern Med. 1969;71(2):353-357.
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