Acute Respiratory Failure Secondary to ACE Inhibitor–Induced Angioedema after Five Years of Lisinopril Therapy

Tariq Sharman^1, , Jeffrey Song¹, Misam Zawit¹ and Una Ijeoma-Nchinda¹

¹Department of Medicine, Heritage College of Osteopathic Medicine, Southern Ohio Medical Center, Ohio University, Portsmouth, Ohio, USA

Cite this paper

Tariq Sharman, Jeffrey Song, Misam Zawit and Una Ijeoma-Nchinda. Acute Respiratory Failure Secondary to ACE Inhibitor–Induced Angioedema after Five Years of Lisinopril Therapy. American Journal of Medical Case Reports. 2020; 8(1):8-10. doi: 10.12691/AJMCR-8-1-2

Abstract

Angiotensin-converting enzyme (ACE) inhibitors are amongst the commonest prescribed medications in the United States and considered to be the leading causes of drug induced angioedema. High bradykinin levels stimulate vasodilation and increased vascular permeability of the post-capillary venules and allow for plasma extravasation into the submucosal tissue, leading to angioedema. Usually, the angioedema occurs within the first week of exposure to therapy, but cases occurring after years of stable ACE inhibitor usage are not uncommon. Here, we present a 43-year-old Caucasian female who developed acute respiratory failure requiring mechanical ventilation secondary to ACEi–induced angioedema after five years of Lisinopril usage. This case will help to increase physicians’ awareness that this potentially fatal complication can still occur after years of ACE inhibitor usage.

Keywords

Angioedema, Angiotensin converting enzyme inhibitor, Bradykinin, des-Arg9-BK, Complement, C4, substance P, ACE

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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