Familial case of hereditary angioneurotic angioedema, caused by deficiency in the C1 inhibitor complement system

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Abstract

This study revealed primary immunodeficiency developing as a result of a genetically mediated quantitative deficiency or a decrease in the activity of the C1 component complement inhibitor in a family clinical case of patients with genetically confirmed hereditary angioedema, who were living in Taldykorgan, Almaty, Republic of Kazakhstan.

Anamnesis data and clinical and laboratory-instrumental indicators were evaluated. In addition to assessing the objective status and general clinical laboratory studies, all patients underwent studies to determine the quantitative content of C4 and C1 inhibitor of the complement component and the presence of a mutation in the SERPING1 gene.

The polymorphism of clinical and anamnestic data did not allow timely identification of specific syndromes and determination of a clinical diagnosis. As a result, specific basic treatment, preventive measures, and preventive intervention associated with traumatic life and medical situations were given late, leading to life-threatening conditions.

The main clinical manifestations of hereditary angioedema are recurrent dense edema, lasting 2–5 days. The skin, upper respiratory tract, and gastrointestinal tract are the organs most involved. Clinical manifestations in patients vary dramatically, from the absence of characteristic symptoms to life-threatening edema, leading to death.

About the authors

Elena F. Kovzel

Corporate Fund «University Medical Center», Program of Clinical Allergology Immunology

Author for correspondence.
Email: Elena.Kovzel@umc.org.kz
ORCID iD: 0000-0002-2383-0264
SPIN-code: 9274-1640

MD, Dr. Sci. (Med.), Professor

Kazakhstan, Astana

Tair T. Nurpeisov

Scientific research Institute of Cardiology and Internal diseases

Email: dr.tt@mail.ru
ORCID iD: 0000-0002-9590-8905
SPIN-code: 2611-7279

MD, Dr. Sci. (Med.), Professor

Kazakhstan, Almaty

Bayan Gani

Corporate Fund «University Medical Center», Program of Clinical Allergology Immunology

Email: gani.bayan96@gmail.com
ORCID iD: 0000-0002-0897-6353
Kazakhstan, Astana

Svetlana A. Volodchenko

Corporate Fund «University Medical Center», Program of Clinical Allergology Immunology

Email: svetlanasv888@mail.ru
ORCID iD: 0000-0002-7577-5172
SPIN-code: 2653-3388
Kazakhstan, Astana

Zhanagul Zh. Zhamanbaeva

Corporate Fund «University Medical Center», Program of Clinical Allergology Immunology

Email: alem2005@mail.ru
SPIN-code: 9530-3672
Kazakhstan, Astana

Asiya B. Syzdykova

Corporate Fund «University Medical Center», Program of Clinical Allergology Immunology

Email: asiya-15@mail.ru
ORCID iD: 0000-0002-4682-7412
Kazakhstan, Astana

Aray Zh. Batyrbaeva

Scientific research Institute of Cardiology and Internal diseases

Email: aikoshny@mail.ru
ORCID iD: 0000-0001-9987-4741
SPIN-code: 6455-2943
Kazakhstan, Almaty

References

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  2. Bork K, Zibat A, Ferrari DM, et al. Hereditäres angioödem in einer familie mit spezifischen mutationen sowohl im plasminogen- als auch im SERPING1-Gen. J Dtsch Dermatol Ges. 2020;18(3):215–224. (In German). doi: 10.1111/ddg.14036_g
  3. Xu YY, Gu JQ, Zhi YX. Hereditary angioedema caused by a premature stop codon mutation in the SERPING1 gene. Clin Transl Allergy. 2020;10(1):53. doi: 10.1186/s13601-020-00360-9
  4. Blanch A, Roche O, Urrutia I, et al. First case of homozygous C1 inhibitor deficiency. J Allergy Clin Immunol. 2007;118(6):1330–1335. doi: 10.1016/j.jaci.2006.07.035
  5. Bork K, Staubach P, Eckardt AJ, Hardt J. Symptoms, course, and complications of abdominal attacks in hereditary angioedema due to C1 inhibitor deficiency. Am J Gastroenterol. 2006;101(3):619–627. doi: 10.1111/j.1572-0241.2006.00492.x
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  7. Maurer M, Magerl M, Betschel S, et al. The international WAO/EAACI guideline for the management of hereditary angioedema--The 2021 revision and update. World Allergy Organ J. 2022;15(3):100627. doi: 10.1016/j.waojou.2022.100627
  8. Bork K. Acquired and hereditary forms of recurrent angioedema: Update of treatment. Allergol Select. 2018;2(1):121–131. doi: 10.5414/ALX1561E
  9. Can PK, Rmentepe EN, Etikan P, et al. Assessment of disease activity and quality of life in patients with recurrent bradykinin-mediated versus mast cell-mediated angioedema. World Allergy Organ J. 2021;14(7):100554. doi: 10.1016/j.waojou.2021.100554

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Genealogical tree in 3 generations.

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3. Fig. 2. Patient B.: dense swelling of the paraorbital part of the left eye and upper lip.

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Copyright (c) 2023 Kovzel E.F., Nurpeisov T.T., Gani B., Volodchenko S.A., Zhamanbaeva Z.Z., Syzdykova A.B., Batyrbaeva A.Z.

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