PMID- 23890533
OWN - NLM
STAT- MEDLINE
DCOM- 20140529
LR  - 20130925
IS  - 0736-4679 (Print)
IS  - 0736-4679 (Linking)
VI  - 45
IP  - 4
DP  - 2013 Oct
TI  - Does angiotensin-converting enzyme inhibitor use exacerbate hereditary 
      angioedema?
PG  - 602-8
LID - S0736-4679(13)00577-5 [pii]
LID - 10.1016/j.jemermed.2013.05.045 [doi]
AB  - BACKGROUND: Approximately 2% of angioedema (AE) patients have a hereditary or an 
      acquired deficiency of the complement 1 (C1) esterase inhibitor (C1 INH) gene. 
      Some case reports indicate an association between angiotensin-converting enzyme 
      inhibitor (ACEI) use and exacerbation of hereditary AE (HAE). OBJECTIVE: The aim 
      of this retrospective study is to investigate the association between HAE and 
      ACEI use in a larger patient population. METHODS: A retrospective chart review of 
      patients who presented with AE and patients with diagnostic serum assays for 
      functional C1 INH, C1 INH antigenic protein, C1q, C1q immune complex (C1q IC), 
      and complement 4 (C4) regardless of medical complaint. Descriptive statistics 
      were used to analyze the data. RESULTS: A total of 1594 patients had complement 
      levels measured (136 C1 INH, 55 C1q, 10 C1q IC, and 1500 C4), of which 156 (9.7%) 
      patients presented with AE. Angiotensin-converting enzyme inhibitor use was 
      documented in 747 (47%) patients. Low C1 INH was detected in one patient with 
      recurrent AE who was not taking ACEI. Another patient who presented with 
      recurrent AE was found to have systemic lupus erythematosus with abnormal C4, 
      C1q, and C1q IC, but normal C1 INH. A low C4 level was present in 94 patients, 4 
      of which had AE. CONCLUSIONS: The risk of exacerbating HAE by ACEI might be 
      present, but we did not find any association in this retrospective study. Further 
      studies are needed to determine the existence of this association.
CI  - Copyright (c) 2013 Elsevier Inc. All rights reserved.
FAU - Hassen, Getaw Worku
AU  - Hassen GW
AD  - Department of Emergency Medicine, NYMC, Metropolitan Hospital Center, New York, 
      New York; Department of Emergency Medicine, Lutheran Medical Center, Brooklyn, 
      York; Department of Emergency Medicine, St. George's University School of 
      Medicine, St. George, Grenada.
FAU - Tu, Ting Jia
AU  - Tu TJ
FAU - Wei, Daniel Hsiang
AU  - Wei DH
FAU - Hwang, Albert
AU  - Hwang A
FAU - Lamothe, Romus
AU  - Lamothe R
FAU - Costea, Ana
AU  - Costea A
FAU - Liu, Lydia Liyun
AU  - Liu LL
FAU - Smith, Tennyson
AU  - Smith T
FAU - Mualim, Felicia
AU  - Mualim F
FAU - Johnston, Paul
AU  - Johnston P
FAU - Ng, Jennifer Ming Wai
AU  - Ng JM
FAU - Usmani, Shakeel
AU  - Usmani S
FAU - Kalantari, Hossein
AU  - Kalantari H
LA  - eng
PT  - Journal Article
DEP - 20130725
PL  - United States
TA  - J Emerg Med
JT  - The Journal of emergency medicine
JID - 8412174
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Complement C1 Inhibitor Protein)
RN  - 0 (Complement C4)
RN  - 80295-33-6 (Complement C1q)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Angioedemas, Hereditary/blood/*chemically induced
MH  - Angiotensin-Converting Enzyme Inhibitors/*adverse effects
MH  - Complement C1 Inhibitor Protein/metabolism
MH  - Complement C1q/metabolism
MH  - Complement C4/metabolism
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
OTO - NOTNLM
OT  - ACEI
OT  - AE
OT  - HAE
OT  - serum complements
EDAT- 2013/07/31 06:00
MHDA- 2014/05/30 06:00
CRDT- 2013/07/30 06:00
PHST- 2012/09/12 00:00 [received]
PHST- 2012/12/20 00:00 [revised]
PHST- 2013/05/01 00:00 [accepted]
PHST- 2013/07/30 06:00 [entrez]
PHST- 2013/07/31 06:00 [pubmed]
PHST- 2014/05/30 06:00 [medline]
AID - S0736-4679(13)00577-5 [pii]
AID - 10.1016/j.jemermed.2013.05.045 [doi]
PST - ppublish
SO  - J Emerg Med. 2013 Oct;45(4):602-8. doi: 10.1016/j.jemermed.2013.05.045. Epub 2013 
      Jul 25.