Philippe Camus, M.D.

Dijon, France

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XXVIII.a

Angioedema (may cause UAO, asphyxia and death)

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

Abadir S, Ipalawatte H, Takher J

A Rare Case of Valsartan-Induced Angioedema.

Cureus 2025 Jun;17;e85623 — 2025 Jun — e85623

Alhowary AA, Odat H, Alali O, Al-Omari A

Intraoperative angioedema induced by angiotensin II receptor blocker: a case report.

Patient safety in surgery 2018;12;27 — 2018 — 27

Soo Hoo GW, Lin HK, Junaid I, Klaustermeyer WB

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

Montoro de Francisco A, García-Luque A, Fernández M, Puerro M

Side effects of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists: are we facing a new syndrome.

The American journal of cardiology 2012 Nov 15;110;1552-3 — 2012 Nov 15 — 1552-3

Shino M, Takahashi K, Murata T, Iida H, Yasuoka Y, Furuya N

Angiotensin II receptor blocker-induced angioedema in the oral floor and epiglottis.

American journal of otolaryngology 2011 Nov-Dec;32;624-6 — 2011 Nov-Dec — 624-6

Kalra A, Cooley C, Palaniswamy C, Kalra A, Zanotti-Cavazzoni SL

Valsartan-induced angioedema in a patient on angiotensin-converting enzyme inhibitor for years: case report and literature review.

American journal of therapeutics 2012 Nov;19;e189-92 — 2012 Nov — e189-92

Wüthrich B

[Regarding: Shuster C, Reinhart WH, Hartmann K, Kuhn M. Angioma induced by ACE inhibitors and angiotensin II receptor antagonists: analysis of 98 cases].

Schweizerische medizinische Wochenschrift 1999 Jul 03;129;1003-4 — 1999 Jul 03 — 1003-4

Schuster C, Reinhart WH, Hartmann K, Kuhn M

[Angioedema induced by ACE inhibitors and angiotensin II-receptor antagonists: analysis of 98 cases].

Schweizerische medizinische Wochenschrift 1999 Mar 06;129;362-9 — 1999 Mar 06 — 362-9