Angioedema and angiotensin converting enzyme inhibitors: a report of 19 cases

La Revue de médecine interne
J-P DucroixM Andrejak

Abstract

Inhibitors of angiotensin-converting enzyme are worldwide used and are a real progress for the treatment of systemic hypertension or cardiac failure and are a real progress. The most common adverse side effect is cough. Angioedema is a sudden and localized edema involving the deeper cutaneous and mucosa tissue lappers. 0.1-0.5% of patients treated by ACE inhibitors could develop angioedema. We report a series of 19 cases, recruited in the Parmacovigilance Center of the University Hospital of Amiens from 1997 to 2003. All the patients had a facial swelling edema at initial presentation. Intestinal mucosa or preputial are misleading localisations. In 1/3 of cases, angioedema appeared after the first administration, in 1/3 of cases it appeared with a delay of 1-2 years. The oropharynx localisation with glottic involvement may need an airway intervention. One patient died from pulmonary distress at home. The pathophysiology is current unknown although there is increasing evidence for bradykinin accumulation involvement. The treatment by ACE inhibitors must be broken off; angiotensin II antagonists may be an alternative treatment, but has to be introduced carefully.

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Citations

Jun 3, 2011·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Slobodan M Janković, Srdjan M Stefanović
Jun 6, 2009·American Journal of Clinical Dermatology·Evangelo Frigas, Miguel A Park
Oct 19, 2007·Farmacia hospitalaria : órgano oficial de expresión científica de la Sociedad Española de Farmacia Hospitalaria·F Llinares TelloS Escrivá Moscardó
Jun 5, 2013·The Journal of Clinical Hypertension·Retsilisitsoe R MoholisaEdward D Sturrock
May 13, 2006·La Revue de médecine interne·E BeaudouinD-A Moneret-Vautrin
Sep 22, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Putul SarkarGeorge Hall
Dec 7, 2007·Surgical and Radiologic Anatomy : SRA·Nihal ApaydinAlaittin Elhan

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