An Essential Problem in Patients with Hereditary Angioedema: Irritable Bowel Syndrome

Abstract

Objective: Hereditary angioedema (HAE) is characterized by attacks of subcutaneous and mucosal edema. HAE usually affects the skin or mucosal tissues of the upper respiratory and gastrointestinal tract. Irritable bowel syndrome (IBS) is one of the diseases in which the abdominal symptoms of HAE may be confused. In this study, we aimed to clarify the role of IBS in clinical presentation and diagnostic delay in HAE. Material and Method: 50 patients with HAE followed in our clinic between January 2013 and April 2023 were included in this study, and hospital records were retrospectively reviewed. Patients with HAE were divided into two groups, those with and without IBS, and evaluated according to Rome IV criteria for diagnosing IBS. Results: The mean age of the study group was 40 ± 13 years, and 60% (n=30) were female. IBS was observed in 30% (n=15) of the patients, and 60% (n=9) had IBS before diagnosing HAE. The frequency of attacks and history of gastrointestinal tract medical/surgical history were more frequent in HAE patients with IBS (p<0.001, p=0.032, respectively). Abdominal symptoms before the diagnosis of HAE and persistent abdominal symptoms other than attacks after the diagnosis of HAE were more common in HAE patients with IBS (p<0.001, p<0.001, respectively). HAE patients with IBS had a more significant delay in diagnosing HAE (p=0.011). Conclusion: Clinicians should keep HAE in mind in patients with suspected IBS or patients presenting with recurrent unexplained abdominal pain.

Keywords

• Hereditary angioedema
• irritable bowel syndrome
• abdominal symptoms
• frequent attacks
• diagnostic delay.

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