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Abstract Introduction We report a rare, classic case of isolated angioedema of the bowel due to C1-esterase inhibitor deficiency. It is a rare presentation and very few cases have been reported worldwide. Angioedema has been classified into three categories. Case presentation A 66-year-old Caucasian man presented with a ten-month history of episodic severe cramping abdominal pain, associated with loose stools. A colonoscopy performed during an acute attack revealed nonspecific colitis. Computed tomography of the abdomen performed at the same time showed a thickened small bowel and ascending colon with a moderate amount of free fluid in the abdomen. Levels of C4 (< 8 mg/dL; reference range 15 to 50 mg/dL), CH50 (< 10 U/mL; reference range 29 to 45 U/ml) and C1 inhibitor (< 4 mg/dL; reference range 14 to 30 mg/dL) were all low, supporting a diagnosis of acquired angioedema with isolated bowel involvement. Our patient's symptoms improved with antihistamine and supportive treatment. Conclusion In addition to a detailed comprehensive medical history, laboratory data and imaging studies are required to confirm a diagnosis of angioedema due to C1 esterase inhibitor deficiency.

The United States Food and Drug Administration and the International Planned Parenthood Federation recommend that women over the age of 40 should utilize forms of contraception other than the pill. This decision was reached as a result of the 1975 clinical papers by Mann and his associates (Mann et al., 1975; Mann & Inman, 1975) and the epidemiological reports of the Royal College of General Practitioners (1977), Mann, Inman & Thorogood (1976) and Vessey, McPherson & Johnson (1977). Several authoritative bodies believed it prudent to suggest that the age limit for oral contraceptive use be lowered to 35, and even to 30 years (Anon, 1977; Planned Parenthood memorandum, 1977). The investigations of Inman & Vessey (1968) point to a precarious rise in mortality figures for women over age 35 on oral contraceptives. [ABSTRACT FROM AUTHOR]

The syndrome is only definitive when resolution occurs with the onset of menses or soon thereafter. Manifestations of PMS include: nervousness, depression, irritability, insomnia, headaches, breast enlargement, abdominal bloating, oedema, gastrointestinal upsets, skin disorders antisocial behavior and psychosexual aberrations. Hormonal changes are probably the main etiological factor and the newest approach to management consists of inhibition of ovulation by means of estradiol implants. Although emotional and psychiatric symptoms are prominent, psychiatric treatment is disappointing. PMS is simply a response to biochemical and metabolic changes following ovulation; distressing PMS represents a psychological maladjustment to these hormonal tides. [ABSTRACT FROM AUTHOR]