Acquired angioedema induced by angiotensin‑converting enzyme inhibitors ‑ experience of a hospital‑based allergy center

Leru,Polliana  Mihaela; Anton,Vlad  Florin; Bocsan,Corina; Muntean,Adriana; Boda,Daniel

doi:10.3892/etm.2020.8474

Acquired angioedema induced by angiotensin‑converting enzyme inhibitors ‑ experience of a hospital‑based allergy center

Authors:
- Polliana Mihaela Leru
- Vlad Florin Anton
- Corina Bocsan
- Adriana Muntean
- Daniel Boda
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Affiliations: Family Medicine Department, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Internal Medicine Department, Colentina Clinical Hospital, 020125 Bucharest, Romania, Department of Pharmacology, Toxicology and Clinical Pharmacology, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania, Department of Immunology and Allergology, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania, Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
Published online on: January 27, 2020 https://doi.org/10.3892/etm.2020.8474
Pages: 68-72

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Abstract

Angiotensin‑converting enzyme inhibitors (ACEIs) represent an important group of pharmacological compounds, largely prescribed for more than 30 years. They have been extensively evaluated in clinical trials, demonstrating significant reduction of morbidity and mortality of patients with cardiovascular diseases, mainly high blood pressure, myocardial infarction, heart failure and stroke. Besides their beneficial effects and a general good safety profile, it was proven that ACEIs might also induce adverse effects in some patients, most notably angioedema (AE) and chronic cough. The occurrence rate of adverse events induced by ACEIs is low, but the number of suffering patients is relatively high, since ACEIs is one of the most frequently prescribed medication worldwide. The aim of our study was to evaluate clinical pattern, risk factors and general management of ACEI‑induced angioedema in a cohort of patients addressed for allergist evaluation in one university hospital in Romania, during a period of 32 months. It was found that ACEI‑induced angioedema (ACEI‑AE) represented more than half of the total number of patients addressed for angioedema without urticaria, with variable clinical and time‑patterns. Most of the patients were referred by general practitioners (GPs) with diagnosis of urticaria or other skin allergy and continued to take ACEIs for months and years after onset of angioedema. We concluded that the awareness of acquired, non‑allergic angioedema induced by ACEI therapy in medical practice is still low and there is a need for improved knowledge and interdisciplinary collaboration in this field.

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