title: [A Case of Life-Threatening Angioedema Occurred During Prolonged Angiotensin-Converting Enzyme Inhibitor Treatment].
abstract: Although angiotensin-converting enzyme (ACE) inhibitors are widely used as the first choice drug for treating hypertension, we have only a superficial understanding of their relationship to angioedema. We report a case of life-threatening angioedema. The case was a 60-year-old man who had been taking an ACE inhibitor for hypertension for 11 years. He visited his home doctor for dyspnea, and tongue and neck swelling. He was transported to our hospital because of the possibility of airway obstruction. On admission, his tongue and neck swelling became more severe. We performed an intubation using an endoscope and started airway management. We also stopped his ACE inhibitor. The severe tongue and neck swelling improved gradually and he was extubated on day 3. On the fifth day he was discharged. We diagnosed angioedema caused by an ACE inhibitor. Although the risk of airway obstruction with ACE inhibitors is acknowledged, we have only a superficial understanding of how prolonged ACE inhibitor treatment induces angioedema. So we should consider angioedema in cases of taking ACE inhibitors, especially in cases of prolonged treatment.
authors.affiliation: Division of Critical Care Medicine, Hospital of the University of Occupational and Environmental, Health, Japan.
authors.forename: Rintaro
authors.initials: R
authors.lastname: Nakamura
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Nihei
authors.forename: Hideaki
authors.initials: H
authors.lastname: Arai
authors.forename: Keiji
authors.initials: K
authors.lastname: Nagata
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Isa
authors.forename: Nobuya
authors.initials: N
authors.lastname: Harayama
authors.forename: Keiji
authors.initials: K
authors.lastname: Aibara
authors.forename: Msayuki
authors.initials: M
authors.lastname: Kamochi
mesh_terms: D000402:Airway Obstruction / Q000139:chemically induced*; D000799:Angioedema / Q000139:chemically induced*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D006801:Humans; D048289:Imidazolidines / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D048289:Imidazolidines; C065166:imidapril