Angioedema induced by angiotensin converting enzyme inhibitors, potentiated by m-TOR inhibitors: Successful treatment with icatibant

摘要

A 65-year-old woman was admitted to the emergency department for an acute dyspnea. She had a history of arterial hypertension treated by quinapril, and a breast cancer for which everolimus was given for 2 months. The physical examination found a severe dyspnea with facial edema, macroglossia, but no urticaria or pruritus (Fig. 1). After failure of orotracheal intubation, an emergency percutaneous dilatational tracheostomy was performed. Cervical computed tomography revealed upper airway obstruction induced by edema of the tongue (see supplementary electronic material). Angioedema induced by angiotensin converting enzyme inhibitors (ACEi), potentiated by everolimus was suspected.