Life threatening angioedema in a patient on ACE inhibitor (ACEI) confined to the upper airway

Qatar Medical Journal
Abdulgafoor Muslim TharayilAbdelhafiz Ali Ahmed Alshamandy

Abstract

ACE inhibitors accounts for 8% of all cases of angioneurotic edema and the overall incidence is 0.1 to 0.7% of patients on ACE inhibitors. It is a leading cause (20-40%) of emergency room visits in the US with angioedema. We report a case of angioedema caused by ACE inhibitors confined to the upper airway after four years on treatment with Lisinopril which persisted for three weeks and required endotracheal intubation and subsequent tracheostomy due to delayed resolution. This case is one of the rare cases presented as upper airway edema which persisted for a long time. A 60-year-old Sudanese male patient with osteoarthritis in both knees underwent bilateral total knee replacement under single-shot epidural anesthesia. He had significant past medical history of type II diabetes, bipolar affective disorder and hypertension managed with Lisinopril for the past four years. Postoperatively after 10 hours the patient desaturated and developed airway obstruction requiring intubation. Laryngoscopy revealed an edematous tongue and upper airway and vocal cords were not visualized. In view of this clinical picture a provisional diagnosis of angioedema secondary to Lisinopril was made and it was discontinued. CT scan of the neck and soft ...Continue Reading

References

Feb 15, 1990·Annals of Internal Medicine·H L Chin, D A Buchan
Jan 1, 1993·The Laryngoscope·T Thompson, M A Frable
Jun 20, 1996·The New England Journal of Medicine·M Cicardi, A Agostoni
Sep 1, 2000·Lancet·F H Messerli, J Nussberger
Sep 18, 2001·The Annals of Otology, Rhinology, and Laryngology·A G ChiuZ E Deeb
Feb 14, 2002·The Journal of Allergy and Clinical Immunology·Mohammed Yousuf Karim, Amina Masood
Oct 16, 2004·Journal of Evaluation in Clinical Practice·Takeshi MorimotoDavid W Bates
Oct 28, 2005·The New England Journal of Medicine·Joseph R Shiber
Nov 27, 2007·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Nazaneen N GrantStanley H Chia
Apr 17, 2008·Hypertension·Michael A Weber, Franz H Messerli
May 3, 2008·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Aleena BanerjiCarlos A Camargo
Dec 1, 2011·Current Allergy and Asthma Reports·Monali Vasekar, Timothy J Craig
Dec 15, 2011·Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology·Amin KananiRichard Warrington
Oct 25, 2012·Allergology International : Official Journal of the Japanese Society of Allergology·Michihiro HideUNKNOWN Japanese Dermatological Association
Nov 28, 2012·Journal of Pharmacy Practice·Johanna L NormanShannon W Finks
Nov 28, 2012·Allergology International : Official Journal of the Japanese Society of Allergology·Naoko Inomata

❮ Previous
Next ❯

Citations

Jul 19, 2019·The Western Journal of Emergency Medicine·Brit Jeffrey LongMichael Gottlieb

❮ Previous
Next ❯

Related Concepts

Related Feeds

Asthma

This feed focuses in Asthma in which your airways narrow and swell. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.

Bipolar Disorder

Bipolar disorder is characterized by manic and/or depressive episodes and associated with uncommon shifts in mood, activity levels, and energy. Discover the latest research this illness here.

CV Disorders & Type 2 Diabetes

This feed focuses on the association of cardiovascular diseases in patients with type 2 diabetes.

Antipsychotic Drugs

Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.

Allergy and Asthma

Allergy and asthma are inflammatory disorders that are triggered by the activation of an allergen-specific regulatory t cell. These t cells become activated when allergens are recognized by allergen-presenting cells. Here is the latest research on allergy and asthma.

© 2022 Meta ULC. All rights reserved