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A 12-year-old girl has recurrent episodes of self-limited colicky abdominal pain and nausea lasting several days. She was recently hospitalized for an episode of difficulty breathing. She has no past medical history, but her mother has a history of attacks of severe abdominal pain and diarrhea. Physical examination is unremarkable. Laboratory tests show decreased serum C4 and C1 esterase inhibitor levels. What drug is contraindicated?

Answer :

Final answer:

The patient's symptoms appear to point to Hereditary Angioedema, a genetic condition that causes swelling. The use of ACE inhibitors is generally contraindicated in this condition as they could worsen the symptoms.

Explanation:

The 12 year-old girl's condition, characterized by recurrent self-limited colicky abdominal pain, nausea and decreased serum C4 and C1 esterase inhibitor levels, indicates she's likely suffering from Hereditary Angioedema (HAE). This is a rare and serious genetic disease that causes bouts of swelling and can affect various body parts like stomach or airways. The symptoms can vary and can also include difficulty in breathing as mentioned in the question. In this condition, ACE inhibitors are generally contraindicated because they can exacerbate the symptoms by further increasing bradykinin levels which is responsible for the swelling in HAE patients.

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