The Drug-Induced Respiratory Disease Website
See PMID 30075570. Review at PMID 28291095. Major risk is UAO, with consequent asphyxia. Can be followed by irreversible hypoxic brain damage/death. See also under VIIIg. May occur in isolation or accompany drug-induced anaphylaxis. Airway angioedema can be in the form of acute swelling of the lips, tongue, mouth floor, uvula, pharynx, larynx, glottis, subglottic area and/or upper trachea. This can cause acute upper airway obstruction (UAO) and asphyxia. May overlap with IVb. Expedient identification the airway by endoscopy and maintenance of airway patency are crucially important, as if the UAO progresses emergent risky tracheostomy can be required. Icatibant may alleviate all manifestations of drug-induced angioedema (PMID: 22936825). Rebound phenomenon can occur after an initial falsely reassuring period of improvement. NPPE (IIg) may occur as a secondary complication. Reviews and series at PMID 20447725, 20667117, 20922352, 22552531, 22936825, 22976464, 25059449. Angioedema can also involve the bowel wall in concomitance, causing abdominal pain or cramping or simulate an acute abdomen (PMID: 20376210, 21785085, 22867837)
Publications
Macroglossia secondary to lisinopril-induced acute angioedema.
Proceedings (Baylor University. Medical Center) 2019 Jan;32;70-72 — 2019 Jan — 70-72
Angiotensin-converting Enzyme Inhibitor Angioedema Requiring Admission to an Intensive Care Unit.
The American journal of medicine 2015 Jul;128;785-9 — 2015 Jul — 785-9
Severe Angioedema Associated With Angiotensin-Converting Enzyme Inhibitor Therapy in Two Patients With Pollen-Food Allergy Syndrome.
Journal of clinical hypertension (Greenwich, Conn.) 2015 Jun;17;493-4 — 2015 Jun — 493-4
Isolated unilateral tongue oedema: the adverse effect of Angiotensin converting enzyme inhibitors.
Current drug safety 2012 Nov 01;7;382-3 — 2012 Nov 01 — 382-3
Life-threatening ACE inhibitor-induced angioedema after eleven years on lisinopril.
Journal of pharmacy practice 2013 Aug;26;382-8 — 2013 Aug — 382-8
Antihypertensive drug-induced angioedema causing upper airway obstruction in children.
International journal of pediatric otorhinolaryngology 2012 Jan;76;14-9 — 2012 Jan — 14-9
A case of airway compromise.
BMJ (Clinical research ed.) 2010 Sep 29;341;c3822 — 2010 Sep 29 — c3822
Acutely swollen tongue in a middle-aged woman.
American family physician 2010 Aug 01;82;279 — 2010 Aug 01 — 279
ACE-I induced angioedema: a case report and review of literature.
Cases journal 2009 Jul 27;2;7181 — 2009 Jul 27 — 7181
Tongue swelling in the recovery room: a case report and discussion of postoperative angioedema.
Journal of clinical anesthesia 2006 May;18;226-9 — 2006 May — 226-9
Images in clinical medicine. Angioedema of the arytenoids.
The New England journal of medicine 2005 Oct 27;353;e15 — 2005 Oct 27 — e15
Angioedema following the intravenous administration of metoprolol.
Chest 1994 Dec;106;1922-3 — 1994 Dec — 1922-3
Isolated uvular angioedema associated with ACE inhibitor use.
The Journal of emergency medicine 1995 May-Jun;13;327-30 — 1995 May-Jun — 327-30
Lisinopril: a nonsulfhydryl angiotensin-converting enzyme inhibitor.
Clinical pharmacy 1988 Sep;7;659-69 — 1988 Sep — 659-69
Angioedema related to angiotensin-converting enzyme inhibitors.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 1990 Jun;102;727-31 — 1990 Jun — 727-31
Fatal angioedema associated with lisinopril.
The Annals of pharmacotherapy 1992 Oct;26;1245-6 — 1992 Oct — 1245-6
Predisposition to and late onset of upper airway obstruction following angiotensin-converting enzyme inhibitor therapy.
Chest 1992 Sep;102;871-4 — 1992 Sep — 871-4