Life-threatening angioedema induced by angiotensin-converting enzyme inhibitor: two case reports

摘要

Izvle?ek Izhodi??a. Angioedem je redek, a lahko zelo resen zaplet jemanja zdravil iz skupine zaviralcev angiotenzinove konvertaze (ACEI). Vzrok je kopi?enje bradikinina, kajti angiotenzinova konvertaza je klju?en encim za njegovo razgradnjo. Opis primerov. V prispevku sta prikazana primera bolnikov z ?ivljenje ogro?ajo?im angioedemom zaradi jemanja ACEI. Oba bolnika sta pred tem ?e imela epizode angioedemov. Angioedem se ni ubla?il niti po injekciji adrenalina. Pri obeh bolnikih je bila intubacija te?avna. Zaklju?ek. V akutni fazi angioedema zaradi ACEI je potrebna skrb za za??ito dihalne poti. Zaviralci bradikininskih receptorjev skraj?ajo trajanje epizode angioedema. Dolgoro?no pa je nujno trajno prenehanje jemanja ACEI. Abstract Background. Angioedema is a rare but potentially very serious complication of treatment with angiotensin converting enzyme inhibitors (ACEI). Angioedema is due to the accumulation of bradykinin, because angiotensin converting enzyme is the key enzyme for its degradation. Case reports. We present two patients with life-threatening angioedema while taking ACEI. Both patients had already had episodes of angioedema. Angioedema didn't respond to adrenaline. In both patients intubation was difficult. Conclusion. In the acute phase of angioedema due to ACEI it is necessary to protect the airways. Bradykinin receptor inhibitors shorten the duration of episodes of angioedema. In the long term it is essential to permanently avoid ACEI.