Abstract
Background
Angiotensin-converting enzyme (ACE) inhibitors are a commonly prescribed and effective
medication to treat hypertension. Although generally well tolerated, about 1% of patients
will experience angioedema, a potentially life-threatening adverse drug reaction.
This reaction is thought to be mediated via a buildup of bradykinin and does not typically
respond to epinephrine, corticosteroids, or antihistamines. Alternative treatment
strategies have been investigated, the bulk of which surround the use of therapies
approved for hereditary angioedema.
Objective
Utilization of C1 esterase inhibitors at our institution was reviewed between 2016
and 2018 for treatment of ACE inhibitor–induced angioedema. We describe the clinical
course of case series, along with a review of current literature.
Discussion
Utilization of C1 esterase inhibitors for treating ACE inhibitor–induced angioedema
is an uncommon therapy and has limited efficacy in our case series. Treatment did
not result in rapid improvement of swelling, prevention of intubation, or prevention
of intensive care unit admission.
Conclusions
Based on our case series, C1 esterase therapy should not be utilized routinely for
ACE inhibitor–induced angioedema and is not expected to prevent intubation in severe
cases.
Keywords
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Article info
Publication history
Published online: December 13, 2019
Accepted:
October 27,
2019
Received in revised form:
October 18,
2019
Received:
June 17,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
