title: Angiotensin-converting enzyme inhibitor (ACE-I)- and angiotensin receptor blocker (ARB)-related angioedema: a neglected issue in daily practice in Greece.
abstract: Several reports on angioedema (AE) related to the use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARB) have been published recently. This study reports on the experience gained at the Ear, Nose, and Throat (ENT) Clinic of the University Hospital of Heraklion, Crete. A retrospective chart review of the patients admitted to this clinic, in a 42-month period (1999-2003), and discharged with a diagnosis ENT code for AE was performed (14 eligible patients). A complementary telephone survey was conducted during January 2005. Ten patients responded to our invitation. Of those patients, five were under ACE-I and one was under ARB treatment during the AE episode. The mean length of time between the onset of symptoms and presentation to the hospital was 4.5 hours (range 0.5-12 hours). The mean duration between the initiation of antihypertensive treatment and AE episode was 26.2 months (range 1-60 months). Patients reported that no information was provided about the possible adverse effects of these drugs. Although AE introduced by ACE-I and ARBs is an uncommon side effect, this case series conveys a key message to primary care physicians.
authors.affiliation: Clinic of Social and Family Medicine, Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Emmanouil K
authors.initials: EK
authors.lastname: Symvoulakis
authors.forename: Dionysios E
authors.initials: DE
authors.lastname: Kyrmizakis
authors.forename: Emmanouil I
authors.initials: EI
authors.lastname: Drivas
authors.forename: John
authors.initials: J
authors.lastname: Bizakis
authors.forename: George A
authors.initials: GA
authors.lastname: Velegrakis
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
mesh_terms: D017668:Age of Onset; D000368:Aged; D000799:Angioedema / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011320:Primary Health Care; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors