Hereditary Angioedema in Pregnancy Complicated by Upper Extremity Deep Venous Thrombosis: A Case Report.

Hereditary angioedema (HAE) is a rare disorder that causes episodes of angioedema due to a mutation in the C1 esterase inhibitor gene (C1-INH). Complications of HAE include intestinal obstruction, asphyxiation, and venous thromboembolism (VTE). In this case, we report a 34-year-old G4P2011 female with HAE at 24 weeks gestation presenting with acute right upper extremity pain and swelling following a peripherally inserted central catheter (PICC) line for HAE treatment infusion, revealing a right upper extremity VTE. Early treatment with Lovenox, PICC line removal, and continuation of HAE therapy via peripheral IV infusion resolved and prevented further angioedema and subsequent VTEs during this patient's pregnancy. This case serves as an example of effective management of HAE complications during pregnancy and supports peripheral IV line usage over PICC lines for medication infusions in pregnant patients with HAE. The overall purpose of this case report is to improve safety outcomes for pregnant patients with HAE by mitigating the risks of PICC line usage and to highlight the significance of VTE inclusion within the differential diagnosis in this population.