Acquired Angioedema With Anti–C1-inhibitor Autoantibodies During Assisted Reproduction Techniques

Tcnicas de reproduccin asistida. C1-inhibitor (C1-INH) deficiency activates the contact system, resulting in increased bradykinin, vascular hyperpermeability, and recurrent, localized, and self-limiting acute angioedema attacks [1]. Angioedema is classified as hereditary (C1-INH-HAE) or acquired (C1-INH-AAE) [1]. C1-INH-HAE is an autosomal dominant inherited disorder caused by mutations in the C1-INH gene, with an estimated prevalence of approximately 1/50 000 inhabitants [1]. C1-INH-AAE is much less prevalent (around 1/500 000) and is often associated with the presence of anti-C1-INH autoantibodies and/or lymphoproliferative disorders [1,2]. Estrogens and pregnancy can worsen the clinical expression of C1-INH-HAE [3-5], whereas the fertility rate is similar in patients with C1-INH-HAE and in the general population [3]. However, to our knowledge, there are no previous reports on pregnancy and C1-INH-AAE.