[Severe oropharyngeal angioedema caused by ACE inhibitor. A case report].
Inhibitors of angiotensin converting enzyme (ACE) are suspected of inducing angioedemas in up to 0.2% of all patients. These angioedemas are mainly localized in the upper airways and therefore can cause severe airway obstruction and even death due to suffocation. We report the case of a 64-year-old man, who underwent emergency tracheotomy because of severe angioedema of the larynx, which was refractory to pharmacological treatment. We conclude that patients with ACE inhibitor-induced angioedemas should be observed by monitoring in an intensive care unit to ensure the possibility of early intubation, because conventional antiallergic-antiedematous therapy by histamine-receptor antagonists and corticosteroids is an insufficient, unreliable form of therapy in severe cases. Especially otolaryngologists should know about this uncommon potentially life-threatening side-effect of ACE inhibitors.
Waldfahrer
F
F
Klinik für Hals-Nasen-Ohrenkranke, Universität Erlangen-Nürnberg.
Leuwer
A
A
Krause
J
J
Iro
H
H
D000799:Angioedema / Q000139:chemically induced*; D002974:Clemastine / Q000008:administration & dosage; D003000:Clonidine / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000628:therapy; D004630:Emergencies; D004656:Enalapril / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy*; D007819:Laryngeal Edema / Q000139:chemically induced* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D011899:Ranitidine / Q000008:administration & dosage; D014140:Tracheotomy
D004656:Enalapril; D011899:Ranitidine; D002974:Clemastine; D011239:Prednisolone; D003000:Clonidine
Schweres oropharyngeales Angioödem durch ACE-Hemmer. Eine Fallbeobachtung.