title: Hereditary angioedema with an estrogen trigger in a 12-year-old.
abstract: BACKGROUND
  Hereditary angioedema (HAE) is rare autosomal dominant genetic disorder, commonly affecting girls around the menarche, which manifests clinically as recurrent episodes of angioedema. Laryngeal edema can lead to asphyxiation and death. Traditionally hormones have been avoided in the management due a reported association with flares in the literature. This case describes an alternative management with a progestin.
  
  
  METHODS
  A 12 year old HAE sufferer failed to receive relief from her symptoms of angioedema with standard treatment. A trial of depot medroxyprogesterone acetate has resulted in resolution of her symptoms for the last 14 months.
  
  
  CONCLUSIONS
  Although estrogens and progestins have been avoided in the management of HAE in the past, the reasons for this are based only on a small number of case reports. In this case, successful treatment with depot medroxyprogesterone acetate indicates that progestins, as an alternative management for estrogen-triggered HAE, certainly warrants further research.
authors.affiliation: Greenslopes Gynecology and Obstetrics Group, Brisbane, Queensland, Australia. Electronic address: zanhmowat@gmail.com.
authors.forename: Alex E
authors.initials: AE
authors.lastname: Mowat
authors.affiliation: Statewide Paediatric and Gynaecology Service and Director of Obstetrics at Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia; University of Queesnsland, School of Medicine, Brisbane, Qld, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kimble
mesh_terms: D002648:Child; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003613:Danazol / Q000627:therapeutic use; D004338:Drug Combinations; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D056828:Hereditary Angioedema Type III / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D003271:Contraceptive Agents, Female; D004338:Drug Combinations; D004965:Estrogen Antagonists; D017258:Medroxyprogesterone Acetate; D003613:Danazol
keywords: Depot medroxyprogesterone acetate; Estrogen; Hereditary angioedema