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Year : 2017  |  Volume : 42  |  Issue : 4  |  Page : 169-171

Acquired angioedema in a chronic lymphocytic leukemia patient in remission: a case report

1 Department of Clinical Pathology, Menoufia University Hospitals, Shebin Elkom, Egypt
2 Department of Clinical Oncology, Menoufia University Hospitals, Shebin Elkom, Egypt

Correspondence Address:
Nahla Osman
Department of Clinical Pathology, Menoufia University Hospitals, ShebinElkom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejh.ejh_5_17

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Abstract Acquired angioedema is a rare but a well-recognized complication of lymphoproliferative disorders. It occurs as a result of overactivation of the compliment system due to reduced C1 esterase inhibitors with subsequent release of bradykinin. A 59-year-old gentleman with chronic lymphocytic leukemia experienced recurrent episodes of angioedema while on chemotherapy. Investigations confirmed low C1 inhibitor activity in a few occasions. Acute episodes were treated with replacement therapy. Chemotherapy was stopped after cycle 4 as remission was achieved. He experienced a further episode of clinically more severe acquired angioedema after stopping chemotherapy. He was treated with C1 inhibitor concentrate in the high-dependency unit. Subsequently, antifibrinolytics were started as long-term prophylaxis. He had no recurrence of angioedema since then. Conclusion High clinical suspicion and early diagnosis of this rare complication of chronic lymphocytic leukemia is crucial for reducing the morbidity and mortality in these patients. Although treatment directed to the underlying condition is beneficial in most cases with angioedema, this is not invariable and chemotherapy cannot be justified for those who are in remission.

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