title: Icatibant in the treatment of Angiotensin-converting enzyme inhibitor-induced angioedema.
abstract: We describe the case of a 75-year-old woman who presented with massive tongue and lip swelling secondary to angiotensin-converting enzyme inhibitor-induced angioedema. An awake fibre-optic intubation was performed because of impending airway obstruction. As there was no improvement in symptoms after 72 hours, the selective bradykinin B2 receptor antagonist icatibant (Firazyr) was administered and the patient's trachea was successfully extubated 36 hours later. To our knowledge this is the first documented case of icatibant being used for the treatment of angiotensin-converting enzyme inhibitor-induced angioedema in the United Kingdom and represents a novel therapeutic option in its management.
authors.affiliation: Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, 1st Floor MIDRU Building, Bordesley Green East, Birmingham B9 5SS, UK.
authors.forename: Neil H
authors.initials: NH
authors.lastname: Crooks
authors.affiliation: Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, 1st Floor MIDRU Building, Bordesley Green East, Birmingham B9 5SS, UK.
authors.forename: Jaimin
authors.initials: J
authors.lastname: Patel
authors.affiliation: Department of Infection and Immunity, Queen Elizabeth Hospital, Birmingham B15 2TH, UK.
authors.forename: Lavanya
authors.initials: L
authors.lastname: Diwakar
authors.affiliation: Perioperative, Critical Care and Trauma Trials Group, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham B15 2TT, UK.
authors.forename: Fang Gao
authors.initials: FG
authors.lastname: Smith