This interesting case developed symptoms that prompted me from a clinical aspect to think of angioedema.
The authors take the view that in a scenario of a minimally raised C1q and a normal C4 concentration in the blood, C1 inhibitor (C1-INH) deficiency or dysfunction is unlikely, and they therefore did not investigate. What merits mention in this context is that a definitive conclusion regarding the presence or exclusion of C1-INH deficiency cannot be drawn on the basis of C1q and C4 measurements but only on the basis of examining the C1-INH concentration and function in the patients’ blood. This is the only way in which a differentiation into the currently known forms of hereditary or acquired angioedema can be made.
In angioedema, this examination is generally required to ensure adequate therapy, an opinion on prognosis and heredity, and preventive measures, and it should therefore be undertaken as a matter of course.
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