title: [Life-threatening swelling of the tongue in antihypertensive therapy with ACE inhibitors].
abstract: Although generally showing a low incidence of side effects, inhibitors of angiotensin-converting enzyme (ACE) may in rare cases induce angioedemas, mainly located in the oro-facial area and larynx. The interval between the beginning of the ACE inhibitor therapy and the occurrence of such angioedemas may range from a few hours to a few years. Here, the case of a 53-year-old man with massive swelling of the tongue after dental surgery is presented who had started with ACE inhibitor therapy only 24 h before. At admission to the clinic, obstruction of the upper airway due to the tongue swelling had already progressed so far that fiberoptic intubation was necessary. Additionally, the patient was treated with corticosteroids, antihistaminics and epinephrine, avoiding any further administration of the ACE inhibitor. The swelling resolved within 48-72 h. Dentists and physicians should take into consideration this potential side effect in patients treated with ACE inhibitors.
authors.affiliation: Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätskrankenhaus Eppendorf.
authors.forename: A
authors.initials: A
authors.lastname: Brandes
authors.forename: R
authors.initials: R
authors.lastname: Bschorer
authors.forename: G
authors.initials: G
authors.lastname: Gehrke
authors.forename: G
authors.initials: G
authors.lastname: Kessler
authors.forename: R
authors.initials: R
authors.lastname: Schmelzle
mesh_terms: D000799:Angioedema / Q000139:chemically induced*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced; D014060:Tongue Diseases / Q000139:chemically induced*; D014081:Tooth Extraction; D014082:Tooth Fractures / Q000601:surgery
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors
vernacular_title: Lebensbedrohliche Zungenschwellung bei antihypertensiver Therapie mit ACE-Hemmern.