Hereditary angioedema with gastrointestinal involvement: Endoscopic appearance

We present the first reported case of hereditary angioedema (HAE) with gast ric involvement to be successfully evaluated by endoscopy both during and a fter an attack. A 31-year-old man who had a family history of angioedema wa s admitted to our hospital with complaints of abdominal pain and swelling o f extremities. Computed tomography scan and endoscopy carried out during th is attack revealed transient gastrointestinal nail edema which, along with decreased levels of serum C4 and C1 inhibitor, confirmed the diagnosis of H AE with gastrointestinal involvement. During the attack, the gastric mucosa was erythematous and edematous, and pal ts of its surface bulged into the gastric lumen, resembling a submucosal tumor, as a result of massive submuc osal edema. During the healing process, a number of small nodules and raise d erosions developed over the entire gastric mucosal surface after healing of prominent gastric edema. Within 55 days, the gastric mucosa had returned to normal. The endoscopic findings for the stomach in HAE have not, to our knowledge, been previously described.