title: Severe angioedema related to ACE inhibitors in patients with a history of idiopathic angioedema.
abstract: Angiotensin converting enzyme (ACE) inhibitors have been associated with the onset of angioedema in a small subset of treated patients. The angioedema commonly involves the face and oropharyngeal tissues and may result in life-threatening airway compromise. The mechanism by which ACE inhibitors precipitate angioedema has not been well-defined, and retrospective analysis of reported cases has failed to identify a group of patients at high risk. We report four cases of ACE inhibitor-related angioedema that required immediate medical intervention. All four cases occurred in patients with a prior history of idiopathic angioedema, an otherwise uncommon clinical entity. These observations suggest that patients with a history of idiopathic angioedema are at increased risk for the development of ACE inhibitor-related angioedema and should be treated cautiously with this class of drugs.
authors.affiliation: Department of Medicine, Northwestern University Medical School, Chicago, ILL 60611-3008.
authors.forename: N
authors.initials: N
authors.lastname: Orfan
authors.forename: R
authors.initials: R
authors.lastname: Patterson
authors.forename: M S
authors.initials: MS
authors.lastname: Dykewicz
mesh_terms: D000328:Adult; D000368:Aged; D000799:Angioedema / Q000139:chemically induced*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D004656:Enalapril / Q000009:adverse effects / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D017706:Lisinopril; D008297:Male
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril; D017706:Lisinopril