title: Angiotensin Converting Enzyme Inhibitor-related Angioedema: A Case of an Unexpected Death.
abstract: Angioedema is an asymmetric non-pitting oedema on face, lips, tongue and mucous membranes; any delay in diagnosis and treatment can be fatal. Treatment with lisinopril as an angiotensin converting enzyme (ACE) inhibitor, can be a reason of angioedema. Here we report a case who developed oral-facial edema four years after using lisinopril/hydrochlorothiazide. Laryngeal oedema is a main cause of death in angioedema. The treatment of choice in angioedema including fresh frozen plasma, C1 inhibitor concentrations and BRK-2 antagonists (bradykinin B2 receptor antagonists) were used. In this case; a 77 years old female patient suffering from hypertension was considered. This patient was suffering two days from swelling on her face and neck. Non- allergic angioedema was distinguished in five major forms; acquired (AAO), hereditary (HAE), renin-angiotensin-aldosterone system (RAAS) blocker-dependent, pseudoallergic angioedema (PAS) and an idiopathic angioedema (IAO). She was admitted to our clinic with the diagnosis of hereditary angioedema. Patient had skin edema and life threatening laryngeal edema. In emergency department treatment was started using intravenous methylprednisolone, diphenydramine as well as inhaled and subcutaneous epinephrine simultaneously. Despite the initial treatment, the patient died due to the insufficient respiration and cardiac arrest. The patient has no history of kidney disease.
authors.affiliation: Department of Internal Medicine, Kafkas University Practice and Research Hospital, Kars, Turkey.
authors.forename: Eray
authors.initials: E
authors.lastname: Atalay
authors.affiliation: Department of Internal Medicine, Kafkas University Practice and Research Hospital, Kars, Turkey.
authors.forename: Mehmet Tamer
authors.initials: MT
authors.lastname: Özdemir
authors.affiliation: Kafkas University Practice and Reserch Hospital Emergency Department Kars, Turkey.
authors.forename: Gülşen
authors.initials: G
authors.lastname: Çiğsar
authors.affiliation: Department of Internal Medicine, Kafkas University Practice and Research Hospital, Kars, Turkey.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Omurca
authors.affiliation: Department of Internal Medicine, Kafkas University Practice and Research Hospital, Kars, Turkey.
authors.forename: Nurullah
authors.initials: N
authors.lastname: Aslan
authors.affiliation: Department of Internal Medicine, Kafkas University Practice and Research Hospital, Kars, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yildiz
authors.affiliation: Medical University of Pleven, Faculty of Medicine Pleven, Bulgaria.
authors.forename: Zehra Bahar
authors.initials: ZB
authors.lastname: Gey
mesh_terms: D000368:Aged; D000799:Angioedema / Q000139:chemically induced*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: Angioedema; Angiotensin converting enzyme inhibitor; Lisinopril