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Drug-induced visceral angioedema.
Prashanth M Thalanayar1, Ibrahim Ghobrial1, Fritz Lubin1
1Department of Internal Medicine, University of Pittsburgh Medical Center, McKeesport, PA, USA.
Journal of Community Hospital Internal Medicine Perspectives
|October 16, 2014
Summary
Angiotensin receptor blockers (ARBs) can cause angioedema, a rare side effect, despite not being linked to bradykinin accumulation like ACE inhibitors. This review explores ACEI- and ARB-induced visceral angioedema.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Gastroenterology
Background:
- Angioedema is a known side effect of angiotensin-converting enzyme inhibitors (ACEIs), linked to bradykinin accumulation.
- Angiotensin receptor blockers (ARBs) are not expected to cause bradykinin-related side effects due to their mechanism of action.
- However, ARB-induced angioedema has been observed, necessitating further investigation.
Purpose of the Study:
- To review the pathophysiology of ACEI- and ARB-induced angioedema.
- To discuss the occurrence and characteristics of visceral angioedema with ACEIs and ARBs.
- To provide an overview of current guidelines regarding these drug-induced conditions.
Main Methods:
- Literature review of existing studies on ACEI- and ARB-induced angioedema.
- Analysis of reported cases of visceral angioedema associated with these drug classes.
- Synthesis of information on underlying mechanisms and clinical presentation.
Main Results:
- ACEIs cause angioedema via bradykinin accumulation.
- ARBs, while not expected to, can induce angioedema.
- Visceral angioedema has been reported with ACEIs but not with ARBs in existing literature.
Conclusions:
- Angioedema is a potential, though uncommon, side effect of ARBs.
- Understanding the pathophysiology of both ACEI- and ARB-induced angioedema is crucial for clinical management.
- Further research is needed to clarify the mechanisms and incidence of ARB-induced visceral angioedema.
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