Late onset angiotensin-converting enzyme induced angioedema: case report and review of the literature.

Angiotensin-converting enzyme inhibitors (ACEI) such as enalapril, captopril, and lisinopril are well established as effective treatments of arterial hypertension and congestive heart failure. They are widely used and generally well tolerated. Angioedema is a rare but serious adverse effect of ACEI therapy. Most frequently, edema involves the face, oral cavity, and the glossopharyngeal or glottic area. Visceral edema induced by ACEI has also occurred. Life threatening and even fatal cases associated with ACEI have been reported. Although angioedema typically occurs within the first weeks of ACEI therapy, some cases with latencies of several months to years have been reported. This paper reports a case of late onset and recurrent angioedema in a patient treated with lisinopril for hypertension. A discussion of ACEI angioedema follows.