PMID- 32002148
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2000-9666 (Print)
IS  - 2000-9666 (Electronic)
IS  - 2000-9666 (Linking)
VI  - 9
IP  - 6
DP  - 2019
TI  - Clinical features of angioedema induced by renin-angiotensin-aldosterone system 
      inhibition: a retrospective analysis of 84 patients.
PG  - 453-459
LID - 10.1080/20009666.2019.1698259 [doi]
AB  - Background and objectives: Bradykinin-mediated angioedema (AE) induced by 
      antihypertensive drugs primarily affect the head and neck region and may occur 
      even after several years of uneventful treatment. Many facts about the clinical 
      course remain unknown. Diagnosis is not easy, as the clinical appearance 
      resembles allergic AE. No specific diagnostic markers are known and no officially 
      approved treatment is currently available. Methods: All patients who presented to 
      the ORL department between 2010 and 2016 with acute AE were included. Those with 
      a history of renin-angiotensin-aldosterone system (RAAS) blocker intake were 
      defined as RAE and their pathophysiological characteristics and clinical course 
      of the disease were analyzed. Results: A total of 84 patients (median age of 71 
      years) with RAE was identified. The majority (80%) was on ACE inhibition. The 
      oral cavity was most often affected. Nearly 60% were medicated for more than 1 
      year before AE occurred. RAE occurred more often during the morning hours. The 
      necessity for emergency intubation and/or tracheostomy was nine times higher in 
      patients with acute RAE compared to patients with AE due to other reasons. 
      Conclusions: Event-free, long-term therapy with an RAAS blocker before the first 
      development of edema does not exclude RAE. RAE is associated with an increased 
      risk for emergency airway management. Abbreviations ACE: Angiotensin Converting 
      Enzyme; ACEi AE: ACE inhibitor-induced angioedema; AE: Angioedema; ARB: 
      Angiotensin II receptor 1 blocker; C1 INH: C1 Inhibitor; CI: Confidence Interval; 
      CRP: C-reactive protein; DPP IV: Dipeptidyl peptidase IV; ENT: Ear, Nose and 
      Throat; HAE: Hereditary Angioedema; ICD 10: International Statistical 
      Classification of Diseases and Related Health Problems, 10th Edition; OR: Odds 
      Ratio; ORL: Otorhinolaryngology; RAAS: Renin-Angiotensin-Aldosterone System; RAE: 
      RAAS-blocker-induced angioedema.
CI  - (c) 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & 
      Francis Group on behalf of Greater Baltimore Medical Center.
FAU - Pfaue, Anja
AU  - Pfaue A
AD  - Department for Otorhinolaryngology, Head and Neck Surgery, Ulm University 
      Hospital, Ulm, Germany.
FAU - Schuler, Patrick J
AU  - Schuler PJ
AD  - Department for Otorhinolaryngology, Head and Neck Surgery, Ulm University 
      Hospital, Ulm, Germany.
FAU - Mayer, Benjamin
AU  - Mayer B
AD  - Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
FAU - Hoffmann, Thomas K
AU  - Hoffmann TK
AD  - Department for Otorhinolaryngology, Head and Neck Surgery, Ulm University 
      Hospital, Ulm, Germany.
FAU - Greve, Jens
AU  - Greve J
AD  - Department for Otorhinolaryngology, Head and Neck Surgery, Ulm University 
      Hospital, Ulm, Germany.
FAU - Hahn, Janina
AU  - Hahn J
AUID- ORCID: 0000-0001-7641-7118
AD  - Department for Otorhinolaryngology, Head and Neck Surgery, Ulm University 
      Hospital, Ulm, Germany.
LA  - eng
PT  - Journal Article
DEP - 20191214
PL  - United States
TA  - J Community Hosp Intern Med Perspect
JT  - Journal of community hospital internal medicine perspectives
JID - 101601396
PMC - PMC6968333
OTO - NOTNLM
OT  - ACE inhibitor
OT  - Angioedema
OT  - RAAS
OT  - bradykinin
EDAT- 2020/02/01 06:00
MHDA- 2020/02/01 06:01
PMCR- 2019/12/14
CRDT- 2020/02/01 06:00
PHST- 2019/09/25 00:00 [received]
PHST- 2019/11/08 00:00 [accepted]
PHST- 2020/02/01 06:00 [entrez]
PHST- 2020/02/01 06:00 [pubmed]
PHST- 2020/02/01 06:01 [medline]
PHST- 2019/12/14 00:00 [pmc-release]
AID - 1698259 [pii]
AID - 10.1080/20009666.2019.1698259 [doi]
PST - epublish
SO  - J Community Hosp Intern Med Perspect. 2019 Dec 14;9(6):453-459. doi: 
      10.1080/20009666.2019.1698259. eCollection 2019.