Hereditary angio-oedema: new clinical observations and autoimmune screening, complement and kallikrein-kinin analyses.
OBJECTIVE
To study clinical and laboratory manifestations of hereditary angio-oedema (HAE).


METHODS
Thirty-three affected members of a kindred of 63.


RESULTS
Oedematous attacks in the skin, mucous membranes and gastrointestinal tract with fluid displacement were elicited by mental and physical stress, minor traumas, dental and surgical procedures, eruption of teeth, tonsillitis, pregnancies, and use of oestrogen-containing pills including menopausal substitution. Every adult woman with symptomatic HAE (n = 11) showed symptoms of urinary tract infections in conjunction with the attacks (P = 0.010), and also experienced more spontaneous abortions or premature labours (P = 0.037) than healthy relatives. Patients with HAE of both sexes more frequently reported heartburn or peptic ulcers (P = 0.002). Rheumatic complaints were reported by 53% of HAE patients and 12% of their unaffected relatives (P = 0.013), but biochemical screening for 18 autoantibodies and quantitation of immunoglobulins did not reveal statistically significant differences between the two groups. C3, prekallikrein, total kininogen, high molecular weight kininogen (HK), alpha-2-macroglobulin and factor XII were not significantly different in HAE patients. In contrast, levels of C1-INH and C4 were depressed and cleaved HK increased in patients compared to unaffected relatives.


CONCLUSIONS
HAE manifests in a variety of ways, and may influence risk of spontaneous abortions and premature labour.
Nielsen
E W
EW
Department of Anaesthesiology, Nordland Central Hospital, Bodø, Norway.
Gran
J T
JT
Straume
B
B
Mellbye
O J
OJ
Johansen
H T
HT
Mollnes
T E
TE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000799:Angioedema / Q000201:enzymology / Q000235:genetics* / Q000276:immunology* / Q000628:therapy; D001327:Autoimmune Diseases / Q000201:enzymology / Q000235:genetics* / Q000276:immunology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003165:Complement System Proteins / Q000378:metabolism*; D015853:Cysteine Proteinase Inhibitors / Q000378:metabolism*; D005260:Female; D006801:Humans; D007610:Kallikreins / Q000378:metabolism*; D007704:Kininogens / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D015985:Precipitating Factors; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology / Q000276:immunology
D015853:Cysteine Proteinase Inhibitors; D007704:Kininogens; D003165:Complement System Proteins; D007610:Kallikreins