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Angioedema as a predominant symptom of Bordetella pertussis infection

A 41-year-old woman was referred to our hospital with a 6-week history of severe angioedema, dyspnoea and coughing. Initial investigations focused on common causes of angioedema. Clinical presentation and resistance to treatment with antihistamines and steroids made histamine-mediated angioedema unl...

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Autores principales: Bal, Christina, Baumgartner, Ruth, Gompelmann, Daniela, Idzko, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929862/
https://www.ncbi.nlm.nih.gov/pubmed/33653842
http://dx.doi.org/10.1136/bcr-2020-239243
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author Bal, Christina
Baumgartner, Ruth
Gompelmann, Daniela
Idzko, Marco
author_facet Bal, Christina
Baumgartner, Ruth
Gompelmann, Daniela
Idzko, Marco
author_sort Bal, Christina
collection PubMed
description A 41-year-old woman was referred to our hospital with a 6-week history of severe angioedema, dyspnoea and coughing. Initial investigations focused on common causes of angioedema. Clinical presentation and resistance to treatment with antihistamines and steroids made histamine-mediated angioedema unlikely. Bradykinin-mediated angioedema, such as hereditary or drug-induced angioedema, was excluded by a thorough history investigation and laboratory testing for C1-esterase and C4. In rare cases, exogen pathogens cause angioedema. After profound testing for respiratory pathogens, Bordetella pertussis toxins IgA and IgG were found to be positive, indicating recent B. pertussis infection. Pertussis toxin may be responsible for increased vascular permeability causing angioedema. With adequate antibiotic treatment, the symptoms resolved quickly. This case is an example of an atypical presentation of B. pertussis infection in an unvaccinated adult. The recent resurgence of pertussis makes early diagnosis and disease prevention by vaccination crucial.
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spelling pubmed-79298622021-03-19 Angioedema as a predominant symptom of Bordetella pertussis infection Bal, Christina Baumgartner, Ruth Gompelmann, Daniela Idzko, Marco BMJ Case Rep Case Report A 41-year-old woman was referred to our hospital with a 6-week history of severe angioedema, dyspnoea and coughing. Initial investigations focused on common causes of angioedema. Clinical presentation and resistance to treatment with antihistamines and steroids made histamine-mediated angioedema unlikely. Bradykinin-mediated angioedema, such as hereditary or drug-induced angioedema, was excluded by a thorough history investigation and laboratory testing for C1-esterase and C4. In rare cases, exogen pathogens cause angioedema. After profound testing for respiratory pathogens, Bordetella pertussis toxins IgA and IgG were found to be positive, indicating recent B. pertussis infection. Pertussis toxin may be responsible for increased vascular permeability causing angioedema. With adequate antibiotic treatment, the symptoms resolved quickly. This case is an example of an atypical presentation of B. pertussis infection in an unvaccinated adult. The recent resurgence of pertussis makes early diagnosis and disease prevention by vaccination crucial. BMJ Publishing Group 2021-03-02 /pmc/articles/PMC7929862/ /pubmed/33653842 http://dx.doi.org/10.1136/bcr-2020-239243 Text en © BMJ Publishing Group Limited 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Case Report
Bal, Christina
Baumgartner, Ruth
Gompelmann, Daniela
Idzko, Marco
Angioedema as a predominant symptom of Bordetella pertussis infection
title Angioedema as a predominant symptom of Bordetella pertussis infection
title_full Angioedema as a predominant symptom of Bordetella pertussis infection
title_fullStr Angioedema as a predominant symptom of Bordetella pertussis infection
title_full_unstemmed Angioedema as a predominant symptom of Bordetella pertussis infection
title_short Angioedema as a predominant symptom of Bordetella pertussis infection
title_sort angioedema as a predominant symptom of bordetella pertussis infection
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929862/
https://www.ncbi.nlm.nih.gov/pubmed/33653842
http://dx.doi.org/10.1136/bcr-2020-239243
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