title: Life-threatening angio-oedema after the first dose of an ACE inhibitor-not an anaphylactic reaction.
abstract: We present a case of a 60-year-old Caucasian woman, with no prior history of swellings, who was admitted to a hospital due to life-threatening angio-oedema. She had, the previous day, been prescribed an ACE inhibitor for her essential hypertension. She had taken one tablet at night-time, and awoke in the morning with a swollen face progressing to involve the tongue and throat within a few hours. On arrival at her doctor's office, her voice had altered. Corticosteroids and antihistamine were administered while awaiting an ambulance. Arriving at the emergency department, she had dyspnoea due to increasingly severe angio-oedema of the upper airways. Neither adrenaline inhalations, intravenously administrated corticosteroids, atropine nor furosemide were effective and the patient soon become bradycardic. A tracheotomy was performed and the patient was placed on a ventilator. She eventually made a full recovery. It was concluded that she had suffered from life-threatening angio-oedema due to her new medication.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Denmark.
authors.forename: Troels
authors.initials: T
authors.lastname: Krogh Nielsen
authors.affiliation: Dermatology and Allergy Center, University Hospital of Odense, Odense, Denmark.
authors.forename: Anette
authors.initials: A
authors.lastname: Bygum
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Denmark.
authors.forename: Eva
authors.initials: E
authors.lastname: Rye Rasmussen
mesh_terms: D000402:Airway Obstruction / Q000139:chemically induced* / Q000601:surgery; D000799:Angioedema / Q000139:chemically induced* / Q000188:drug therapy; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D001920:Bradykinin / Q000378:metabolism; D005260:Female; D006801:Humans; D008875:Middle Aged; D014140:Tracheotomy
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D001920:Bradykinin