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ACE Inhibitor-Induced Angioedema of the Bowel.
Tabitha Campbell1, Bradley Peckler, Raleigh David Hackstadt
1College of Medicine, University of South Florida, Tampa, FL 33606, USA.
Case Reports in Medicine
|January 7, 2011
Summary
Angiotensin converting enzyme inhibitor (ACEI)-induced intestinal angioedema is rare but serious. Prompt ACEI withdrawal is key for symptom resolution and avoiding invasive procedures.
Area of Science:
- Gastroenterology
- Pharmacology
- Internal Medicine
Background:
- Angiotensin converting enzyme inhibitors (ACEIs) are widely prescribed for hypertension and heart failure.
- ACEI-induced angioedema is a known, albeit uncommon, adverse effect.
- Intestinal angioedema is a particularly rare and often overlooked manifestation.
Observation:
- A case of a 45-year-old Hispanic female presenting with small bowel angioedema, followed by facial and oral pharyngeal angioedema.
- Typical presentation includes abdominal pain, nausea, vomiting, and diarrhea in middle-aged females on ACEI therapy.
- Diagnosis requires a high index of suspicion as it is a diagnosis of exclusion.
Findings:
- ACEI-induced intestinal angioedema presents with gastrointestinal symptoms.
- Symptoms can progress to involve other areas like the face and pharynx.
- Resolution typically occurs within 24-48 hours after discontinuing the offending ACEI medication.
Implications:
- Early recognition and ACEI withdrawal are crucial for effective management.
- Discontinuation of ACEI can prevent unnecessary diagnostic procedures and patient distress.
- Increased physician awareness can improve patient outcomes for this rare complication.
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