Thatchai Kampitak1. 1. Department of Internal Medicine, Chulalongkorn University Hospital, Bangkok, Thailand. thatchai_k@yahoo.com
Abstract
BACKGROUND: Angioedema due to angiotensin-converting enzyme inhibitors (ACEIs) therapy occurs not infrequently and is sometimes associated with life-threatening conditions. CASE SUMMARY: A 59-year-old woman presented with recurrent angioedema of the tongue complicated by upper airway obstruction which required endotracheal intubation. Laboratory tests including complement levels were normal. ACEI-associated angioedema precipitated by NSAIDs was suspected. Her condition improved after discontinuation of imidapril and diclofenac without other specific treatment. DISCUSSION: ACEIs, and in particular concomitant use with NSAIDs, should be avoided in patients with a history of angioedema because continuing administration tends to lead to more severe attacks.
BACKGROUND:Angioedema due to angiotensin-converting enzyme inhibitors (ACEIs) therapy occurs not infrequently and is sometimes associated with life-threatening conditions. CASE SUMMARY: A 59-year-old woman presented with recurrent angioedema of the tongue complicated by upper airway obstruction which required endotracheal intubation. Laboratory tests including complement levels were normal. ACEI-associated angioedema precipitated by NSAIDs was suspected. Her condition improved after discontinuation of imidapril and diclofenac without other specific treatment. DISCUSSION: ACEIs, and in particular concomitant use with NSAIDs, should be avoided in patients with a history of angioedema because continuing administration tends to lead to more severe attacks.
Authors: G Bertazzoni; M T Spina; M G Scarpellini; F Buccelletti; M De Simone; M Gregori; V Valeriano; F R Pugliese; M P Ruggieri; M Magnanti; B Susi; L Minetola; L Zulli; F D'Ambrogio Journal: Intern Emerg Med Date: 2013-11-09 Impact factor: 3.397