Case Report: Anesthetic Approach for Patient with Hereditary Angioedema [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-90522

Case Report: Anesthetic Approach for Patient with Hereditary Angioedema

Maize Cordeiro Melo, WALKIRIA BOAS, Marcos Daniel faria, Alyne Andrade Lima, Rafaela Souza
Hospital of the Clinics of the Federal University of Minas Gerais, Brazil

The Hereditary Angioedema (HEA), a disease caused by mutation in the gene that encodes the production of the fraction C1 in the complement (C1-INH), is a rare pathology (1/50.000) that causes swelling of the skin and sub-mucous in various organs, either naturally triggered or provoked by physical and psychological traumas, infections, and by the use of nonsteroidal anti-inflammatory drugs(NAIDs) and angiotensin converting enzyme inhibitor(ACEIs). Surgical trauma may spur the HEA crisis, implying some complication such as the swelling of the respiratory tracts as well as hemodynamic instability. Thus, the pre-surgical dealing with HEA patients requires a specific plan ensuring short term prophylaxis, careful intra-operation management, rescue therapy and intensive post-surgery care. We present a report on a video-laparoscopic cholecystectomy approach for a HEA patient, a 28 years old woman diagnosed with asthma and HEA with symptomatic choledocholithiasis. We opted for short term prophylaxis and immunology: intravenous application of C1-INH. Ultrasonography imaging showed arterial wall edema, which could correspond to a manifestation of C1-INH deficiency in the wall of the manipulated arteries during ultrasonography-guided puncture. Once the patient recovered consciousness, she was transferred to the intensive care unit and was discharged on the sixth day of hospitalization.

Keywords: Anesthesia, Hereditary Angioedema, C1 Complement Inhibitory Protein




Corresponding Author: Maize Cordeiro Melo, Brazil


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