Angioedema-like facial swelling as a first manifestation of systemic lupus erythematosus

Abstract

Angioedma is a group of disorders with multifactorial etiology but a similar clinical expresion, is characterized by swelling of subcutaneous or submucosal tissue. Systemic lupus erythematosus(SLE) Is a chronic multi-systemtic disease characterized by inflammation and tissue damage resulting from deposition of auto-antibodies and immune complex. We experienced a case of angioedema which was the first manifestation of SLE in 24-year old female patient. She had suffered from severe facial edema and multiple lymphadenopathy for six months and she also had pleural effusion, positive anti-nuclear and anti-DNA antibody test. Marked de crease of C3 and C4 levels was noted with normal antigenic level, and activity of Cl esterase inhibitor. The angioedema was not improved with anti-hitamine agents and instead disappeared with use of corticosteroid and non-steroidal anti-inflammatory drugs. Complement levels nor-malized after corticosteroid treatment. We report a case of SLE which initial manifestation was angioedema.