<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 47-year-old male presents to the emergency department with facial swelling and trouble breathing. These symptoms began this morning and progressively worsened over the past several hours. Vital signs are as follows: T 37.7, HR 108, BP 12076, RR 20, and SpO2 96. Physical examination reveals nonpitting swelling of the face, hands, and arms as well as edema of the tongue and mucus membranes of the mouth and pharynx. The patient reports several episodes of mild facial swelling that occurred during childhood between the ages of 5-18, but he does not recall seeing a physician or receiving treatment for this. His medical history is otherwise negative, except for mild hypertension for which his primary care physician initiated lisinopril 2 weeks ago. This patient most likely has which of the following underlying abnormalities?? A: MHC class I deficiency, B: Defective lysosomal storage proteins, C: Lack of NADPH oxidase, D: Defect in cytoskeletal glycoprotein, E: Deficiency of C1 esterase inhibitor,  <response>: This is a patient with a history of recurrent episodes of facial swelling that began in childhood, now presenting with acute facial swelling, edema of the tongue and oral mucosa, and trouble breathing. The key findings are recurrent angioedema without urticaria beginning in childhood, which narrows the differential diagnosis. Choice A, MHC class I deficiency, would not present with these findings. MHC class I deficiency causes recurrent viral infections.Choice B, defective lysosomal storage proteins, also does not match this presentation. Lysosomal storage diseases cause developmental delay and neurologic symptoms. Choice C, lack of NADPH oxidase, causes chronic granulomatous disease, which presents with recurrent bacterial and fungal infections, not angioedema.Choice D, defect in cytoskeletal glycoprotein, is associated with Ehlers-Danlos syndrome, which causes joint hypermobility and skin findings. Choice E, deficiency of C1 esterase inhibitor, is the most likely diagnosis. C1 esterase inhibitor deficiency causes hereditary angioedema, which presents with recurrent angioedema without urticaria beginning in childhood or adolescence. The lack of C1 inhibitor allows unchecked activation of the complement cascade.E: Deficiency of C1 esterase inhibitor 