Abstract
Angioedema is a rare but potentially life threatening condition commonly associated with angiotensin-converting enzyme inhibitors (ACEIs). The incidence is approximately 0.1–0.2% and may occur within the first week to several years of taking an ACEI. We present a case of a 37-year-old African American male who was uneventfully taking a drug combination of quinapril and hydrochlorothiazide. When his medication was changed to lisinopril he developed an acute swelling of his lower lip and chin on fifth dose. The angioedema subsided within 24 hours after discontinuation of lisinopril. Therefore, this suggests that future treatment with ACEIs, as well as angiotensin receptor blockers (ARBs), is not recommended in this type of patient.
Highlights
Angioedema presents as an acute, painless, nonpruritic and well-circumscribed edema of subcutaneous and submucosal tissues that usually resolves in 24 to 48 hours.[1]
CASE REPORT A 37-year-old African American male with a history of hypertension presented to the emergency room complaining of a swollen lower lip and chin when he arose in the morning
He denied shortness of breath, wheezing or voice changes. He was being treated with a combination of quinapril/hydrochlorothiazide (Accureticw) for three years without adverse effects
Summary
Angioedema presents as an acute, painless, nonpruritic and well-circumscribed edema of subcutaneous and submucosal tissues that usually resolves in 24 to 48 hours.[1]. CASE REPORT A 37-year-old African American male with a history of hypertension presented to the emergency room complaining of a swollen lower lip and chin when he arose in the morning He denied shortness of breath, wheezing or voice changes. He discontinued all medications for three months and he started lisinopril (20 mg/day) 5 days prior to developing angioedema Five years previously, he had an acute allergic reaction with swelling of his lower lip, chin and mild dyspnea three hours after eating an avocado. This allergic reaction resolved spontaneously within 20 minutes He denies recent contact with insects, consumption of foods such as avocado, nuts, shellfish, milk, eggs, illicit drug use, over the counter medications or herbal remedies.
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