Volume 200 - Issue 3
Hereditary cause of severe recurrent bowel swelling that requires targeted therapy
Authors: Suran L Fernando and Jamma Li
Med J Aust 2014; 200 (3): 179. || doi: 10.5694/mja13.10306
Published online: 17 February 2014
Published online: 17 February 2014
A mystery solved after 15 years of pain and swelling
A36-year-old woman presented to an emergency department with severe abdominal pain. She had a 15-year history of recurrent abdominal pain and cutaneous angio-oedema without accompanying urticaria. The pain and swelling were refractory to treatment with opiates, corticosteroids and adrenalin. The patient was well between attacks. Her mother had a history of similar attacks. Results of a full blood count and liver function tests were normal, as were serum levels of β-human chorionic gonadotropin, lipase and C-reactive protein. A computed tomography scan of her abdomen showed mural inflammation of the ascending colon consistent with angio-oedema (arrows).
A provisional diagnosis of hereditary angio-oedema was made. Administration of C1 esterase inhibitor promptly ameliorated the pain. Alternatively, icatibant (a bradykinin antagonist) could have been used. Results of subsequent laboratory investigations — namely low C4 level, low level and function of C1 inhibitor and normal level of C1q — confirmed the diagnosis.
Early-Onset Colorectal Cancer With Liver-Only Metastases: A Retrospective Cohort Study Integrating Prospectively Collected Real-World Clinical and Molecular Data From an Australian National Database (2009–2024) to Guide Treatment Planning
Savio G. Barreto, Christos S. Karapetis, Shahid Ullah, Matthew Burge, Susan Caird, Angus Campbell, Azim Jalali, Ross Jennens, Muhammad A. Khattak, Belinda Lee, Stephanie H. Lim, Shehara Mendis, Louise Nott, Timothy J. Price, Jeremy D. Shapiro, Jeanne Tie, Javier Torres, Colin Williams, Rachel Wong, Vanessa Wong, Peter Gibbs
Australian Pathways for Specialist Pain Management and Early Palliative Care for People With Pancreatic Cancer: Developed Using a Community Consensus Approach
Jennifer Philip, Melanie R. Lovell, Kylee Bellingham, Gail Garvey, Gregory B. Crawford, Nicole M. Rankin, Kara Burns, Isabel Young, Vivienne Milch, Dorothy Keefe, Katrina Anderson, James Lawson, Meinir Krishnasamy
Cause‐specific mortality among Queensland people with cirrhosis, by cirrhosis aetiology and decompensation status, 2007–22: a retrospective cohort study
Vikas Bhasker, Jessica R Fong, Paul J Clark, Gunter F Hartel, Richard Skoien, James O’Beirne, Elizabeth E Powell, Patricia C Valery
Clinical practice guidelines for hepatocellular carcinoma surveillance for people at high risk in Australia: summary of recommendations
Jacob George, Nicole L Allard, Stuart K Roberts, Leon A Adams, Jane Davies, Behzad Hajarizadeh, Jennifer H MacLachlan, Suzanne E Mahady, Rosalie Altus, Catherine Brown, David C Fry, Belinda Greenwood‐Smith, Natali Smud, Patricia C Valery, Nafisa Yussf, Kate Broun, Denise Campbell, Karen Canfell, Chelsea Carle Harrison, Victoria Freeman, Paul Grogan, Catherine Holliday, Suzanne Hughes, Anna Kelly, Cathelijne Kemenade, Claire Latumahina, Amanda McAtamney, Megan Varlow, Joachim Worthington, Susan Yuill, Eleonora Feletto
Assessment of metabolic dysfunction‐associated fatty liver disease in primary care: a consensus statement summary
Leon A Adams, William W Kemp, Kate R Muller, Elizabeth E Powell, Stuart K Roberts, Luis Calzadilla Bertot, Stephanie Best, Gary Deed, Jon D Emery, Samantha L Hocking, Graham R Jones, John S Lubel, Sinead Sheils, Stephen M Twigg, Gerald F Watts, Jacob George
Treatment outcomes for people with hepatitis C referred to tertiary care in Victoria, 2021–22: a retrospective observational study
Elly Layton, Nicole Matthews, Brendan Quinn, Nasra Higgins, Gabrielle Lindeman, Mielle Abbott, Jennifer MacLachlan, Elizabeth Birbilis, Margaret E Hellard, Joseph Doyle, Benjamin C Cowie, Mark Stoové