[Acute angioneurotic edema due to ACE inhibitors]

Acute angioneurotic edema due to angiotensin converting enzyme (ACE) inhibitors usually develops shortly after therapy has been started. In this case, hypopharyngeal edema occurred with a delay of nine days. It required endotracheal intubation and could only be differentiated from an inflammatory process by examination under general anesthesia. The mechanism of action of ACE inhibitors, the pathogenesis of angioneurotic edema, its therapy outside as well as in the hospital, and the case described are being discussed. It is concluded that severe reactions induced by ACE inhibitors must be expected even after considerable time of therapy.