ACE inhibitor associated with recurrent, intermittent parotid gland swelling

Abstract

Objectives: We describe the first published case of recurrent, intermittent, unilateral parotid gland swelling in an adult female that was the result of ACE inhibitor associated angioedema. Methods: Case report of an adult female with multiple presentations of unilateral parotid gland swelling. Results: Trials of multiple antibiotics, antihistamines, and other treatments failed to resolve the intermittent course of this patient’s parotid gland swelling. Once the swelling began to progress in a medial direction, we decided to stop her ACE inhibitor therapy and now have more than 8 months of follow-up with no further swelling episodes. We show CT findings with resolution of parotid swelling. Conclusion: ACE inhibitors are successfully used to treat hypertension and congestive heart failure. However, angioedema is an uncommon but potentially life-threatening side effect of ACE inhibitor therapy that may present early or be delayed in the course of therapy. Until now, isolated parotid swelling has not been related to ACE-I associated angioedema, but should be considered in cases of recurrent parotid edema.