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. 2010 Jul;2(3):195-8.
doi: 10.4168/aair.2010.2.3.195. Epub 2010 May 6.

Angiotensin-converting enzyme inhibitors and angioedema

Mario Sánchez-Borges  1 , Luis A González-Aveledo
Affiliations

Angiotensin-converting enzyme inhibitors and angioedema

Mario Sánchez-Borges et al. Allergy Asthma Immunol Res. 2010 Jul.

Abstract

Purpose: To investigate the incidence and clinical characteristics of angioedema associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) in an outpatient allergy department.

Methods: A retrospective review of medical records of new patients seen in an allergy clinic. Demographic and clinical data of patients with ACEI-induced angioedema were analyzed.

Results: Nine (0.37%) out of 2,421 new patients attending the allergy clinic developed ACEI-associated angioedema. Enalapril was the drug most frequently incriminated. The onset of the angioedema was as early as after the first dose or as late as 2 years after beginning treatment. Six patients experienced life-threatening angioedema involving the tongue, oropharynx, or larynx, and two patients required transfer to the intensive care unit. One patient required a tracheostomy.

Conclusions: Angiotensin-converting enzyme inhibitor treatment is often responsible for angioedema, especially involving the upper airways. Due to the high proportion of the population exposed to ACEIs and to the severity of this adverse effect, it is important that physicians consider ACEIs as possible inducers when evaluating patients with acute or recurrent angioedema.

Keywords: Angiotensin-converting enzyme inhibitors; angioedema; bradykinin; captopril; enalapril.

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Conflict of interest statement

There are no financial or other issues that might lead to conflict of interest.

Figures

Fig. 1
Fig. 1
(A) A male, 51 years old black patient who experienced diffuse facial and lip angioedema during treatment with enalapril. (B) The same patient as in (A). Notice angioedema resolution after 6 days of enalapril discontinuation.
See this image and copyright information in PMC

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