ANGIOTENSIN-CONVERTING ENZYME INHIBITOR-INDUCED ANGIOEDEMA - LATE-ONSET, IRREGULAR COURSE, AND POTENTIAL ROLE OF TRIGGERS

Angioedema is a rare but potentially life-threatening adverse effect o f angiotensin-converting enzyme inhibitors (ACEI) which usually occurs within the first weeks of therapy. We report three patients in whom A CEI-induced angioedema began with a late onset of 12-33 months, and wh o had an irregular, unpredictable course under ACEI therapy In two pat ients, other drugs or trauma appeared to trigger some of the episodes. After withdrawal of the ACEI, the trigger drugs were well tolerated i n provocation tests and upon re-exposure. To avoid putting some patien ts unnecessarily at risk for long periods, one should consider this ir regular pattern of ACEI-induced angioedema and regularly monitor patie nts for this adverse effect.