ACE – Inhibitor Induced Angioedema With Acute Kidney Failure : A Uniqe Case in Our Emergency Department

Abstract

Background Angiotensin-converting enzyme (ACE) inhibitors are a commonly prescribed and effective medication to treat hypertension [1] . ACE inhibitors are the leading cause of drug-induced angioedema in the United States because they are so widely prescribed. ACE inhibitör anjioedema is mediated by bradykinins and less than 1% of those taking these medications may develop it [2]. Patients most commonly present with swelling of the lips, tongue, or face. Angioedema is an asymmetric, nonpitting swelling of the subcutaneous or submucosal tissues that most commonly affects nondependent areas. There is an absence of itching or urticaria in ACE inhibitor-induced angioedema, and the presence of urticaria suggests a different group of etiologies [3]. While this situation is considered rare, acute kidney failure findings with progressive angioedema are even more rare. Case Presentation We present a case of a 25-year-old man who lives with IgA nephritis presented with acute kidney failure findings and angioedema of the upper lip had progressed to the tongue and oropharynx during his treatment in the emergency department. Conclusions Our patient was unique in that symmetric lip swelling and acute kidney failure had completely improved. It is useful to discontinue the use of ACEI medications in patients who present with angioedema and initiate a new class of antihypertensive.