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Nicholas Orfan, MD; Roy Patterson, MD; Mark S. Dykewicz, MD

JAMA. 1990;264(10):1287-1289.

Abstract
Angiotensin converting enzyme (ACE) inhibitors have been associated with the onset of angioedema in a small subset of treated patients. The angioedema commonly involves the face and oropharyngeal tissues and may result in life-threatening airway compromise. The mechanism by which ACE inhibitors precipitate angioedema has not been well-defined, and retrospective analysis of reported cases has failed to identify a group of patients at high risk. We report four cases of ACE inhibitor—related angioedema that required immediate medical intervention. All four cases occurred in patients with a prior history of idiopathic angioedema, an otherwise uncommon clinical entity. These observations suggest that patients with a history of idiopathic angioedema are at increased risk for the development of ACE inhibitor—related angioedema and should be treated cautiously with this class of drugs.

(JAMA. 1990;264:1287-1289)

Author Affiliations
From the Section of Allergy—Immunology, Department of Medicine, Northwestern University Medical School, Chicago, Ill. Dr Dykewicz is now with the Department of Allergy/Immunology, St Louis University School of Medicine.

Footnotes
Reprint requests to Northwestern University Medical School, Section of Allergy—Immunology, Department of Medicine, 303 E Chicago Ave, Chicago, IL 60611-3008 (Dr Patterson).

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