A 11-year-old girl is being evaluated for recurrent episodes of self-limited colicky abdominal pain and nausea lasting several days. She was also recently hospitalized for an episode of difficulty breathing. The patient has no significant past medical history, but her mother has a history of attacks of severe abdominal pain and diarrhea. Physical examination is unremarkable. Laboratory evaluation reveals decreased serum complement C4 and C1 esterase inhibitor levels. Which of the following drugs is contraindicated in this patient?

Question

A 11-year-old girl is being evaluated for recurrent episodes of self-limited colicky abdominal pain and nausea lasting several days.  She was also recently hospitalized for an episode of difficulty breathing.  The patient has no significant past medical history, but her mother has a history of attacks of severe abdominal pain and diarrhea.  Physical examination is unremarkable.  Laboratory evaluation reveals decreased serum complement C4 and C1 esterase inhibitor levels.  Which of the following drugs is contraindicated in this patient?

Quizplus · Accepted Answer

Eductional Objective: Angioedema can be hereditary (autosomal dominant) or acquired (associated with angiotensin-converting enzyme [ACE] inhibitor treatment).  In hereditary angioedema, low C1 esterase inhibitor activity leads to increases in bradykinin activity.  ACE inhibitors should not be used in these patients.

A 11-Year-Old Girl Is Being Evaluated for Recurrent Episodes of Self-Limited