Angiotensin converting enzyme inhibitor-related angioedema: onset, presentation, and management.

Abstract

OBJECTIVE:

This study aimed to determine the duration of use, presentation, and management of angiotensin converting enzyme (ACE) inhibitor-related angioedema patients at an urban academic medical center.

METHODS:

Retrospective chart review.

RESULTS:

Eighty-eight patients who presented with ACE inhibitor-related angioedema between January 1, 2012, and December 31, 2012, were identified. They presented anywhere from 1 day to 20 years after starting an ACE inhibitor. About half the patients (50.7%) presented after taking an ACE inhibitor for at least 1 year. Fifty-five patients were female (62.5%). Twenty-eight patients (31.8%) had an airway intervention with 27 intubated and 1 requiring cricothyroidotomy. Six patients were intubated after more than 1 flexible laryngoscopy. The percentage of patients with involvement of the face, lips, tongue, floor of mouth, soft palate/uvula, and larynx were 12.5%, 60.2%, 39.7%, 6.8%, 17.0%, and 29.5%, respectively. Sixty-eight percent of patients with laryngeal edema were intubated. The majority of patients were treated with a corticosteroid and H1 and H2 receptor antagonists.

CONCLUSION:

Angioedema can occur at any time after starting ACE inhibitor use, with nearly half occurring after 1 year of use. Laryngeal involvement occurred in a minority of patients, but most of these patients were felt to require airway protection.

• Authors: Norman J Chan, Ahmed M S Soliman
• Journal: The Annals of otology, rhinology, and laryngology (Ann Otol Rhinol Laryngol) Vol. 124 Issue 2 Pg. 89-96 (Feb 2015) ISSN: 0003-4894 [Print] United States
• PMID: 25059449 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2014.

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Anti-Allergic Agents

Topics

• Academic Medical Centers (statistics & numerical data)
• Airway Management (methods)
• Angioedema (chemically induced, complications, diagnosis, physiopathology, therapy)
• Angiotensin-Converting Enzyme Inhibitors (administration & dosage, adverse effects, classification)
• Anti-Allergic Agents (administration & dosage)
• Female
• Hospitals, Urban (statistics & numerical data)
• Humans
• Intubation, Intratracheal (methods)
• Laryngeal Edema (diagnosis, etiology, physiopathology, surgery)
• Laryngoscopy (methods)
• Male
• Middle Aged
• Otorhinolaryngologic Surgical Procedures (methods)
• Pennsylvania
• Retrospective Studies
• Risk Factors
• Time Factors