You are here

Article Text

Article menu
Download PDFPDF
Psychiatry
Management dilemma: managing bipolar affective disorder in a patient with hereditary angioedema
  1. Isuri Upeksha Wimalasiri1,2,
  2. Nikhil Jain1,3 and
  3. Mahesh Jayaram1,3
  1. 1Mental Health and Wellbeing Services, Western Health, Sunshine, Victoria, Australia
  2. 2Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
  3. 3Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne , Melbourne, Victoria, Australia
  1. Correspondence to Dr Isuri Upeksha Wimalasiri; isuri.wimalasiri{at}wh.org.au

Abstract

Hereditary angioedema (HAE) is a rare autosomal dominant disorder caused by the deficiency or dysfunction of C1 esterase inhibitors. We present a case of a female in her 50s with HAE and bipolar affective disorder (BPAD). She has experienced severe depressive and manic episodes with significant disruption to her life. She has also had potentially life-threatening episodes of recurrent angioedema with severe facial and body swelling and post-pharyngeal symptoms.

She presented to us with a depressive episode with suicidal ideation. Her angioedema was flared by both psychological stressors and psychotropic medications. Choosing the correct mood stabiliser without triggering angioedema was a major challenge in her treatment. Also, psychosocial interventions and frequent liaison with her immunology team were necessary to provide her with optimum care in the community. Here, we discuss the challenges we faced and how we overcame them in managing this rare presentation of coexisting BPAD and HAE.

  • Bipolar I disorder
  • Immunology
  • Drug interactions
  • Unwanted effects / adverse reactions
  • Psychiatry (drugs and medicines)

https://doi.org/10.1136/bcr-2024-260597

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • X @isu_w1206

    • Contributors IUW, NJ and MJ were responsible for drafting the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, critical revision for important intellectual content and giving final approval of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.