[ACE inhibitor-induced angioedema in the head and neck region. A matter of time?].
BACKGROUND
Angioedema in the head and neck region is potentially life-threatening and may occur as a side effect of inhibitors of the angiotensin-converting-enzyme (ACEI). So far, little is known about the time between the first application of ACEI and the occurrence of angioedema, or of possible cofactors and laboratory changes.


METHODS
A total of 21 patients with angioedema during the course of ACEI treatment were compared to 11 patients with angioedema of unknown cause. These were retrospectively analysed for the following criteria: (1) duration of ACEI medication, (2) leading and concomitant diseases, (3) history of allergies, (4) co-medication, (5) laboratory changes, (6) treatment success, and (7) manifestation of recurrent episodes.


RESULTS
The mean interval between the initiation of ACEI therapy and the first occurrence of angioedema exceeded 2 years. Values for the acute phase proteins C-reactive protein (CRP) and fibrinogen were significantly increased in the ACEI group compared to the control group.


CONCLUSIONS
In any case of angioedema in the head and neck region, a side effect of ACEI must be taken into consideration even if the medication has been taken for months or years.
Bas
M
M
Hals-Nasen-Ohren-Klinik, Universitätsklinikum Düsseldorf.
Kojda
G
G
Bier
H
H
Hoffmann
T K
TK
D000328:Adult; D000368:Aged; D000799:Angioedema / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009131:Muscle, Smooth, Vascular / Q000187:drug effects / Q000503:physiopathology; D010038:Otorhinolaryngologic Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D012008:Recurrence; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D005340:Fibrinogen; D002097:C-Reactive Protein