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Enalapril-Induced Angioedema: Two Case Reports in a Rural Health Facility in Kenya
Tolerability, a good safety profile, affordability, and a preponderance to afford cardio-renal protection in patients with diabetes make enalapril one of the most commonly prescribed angiotensin-converting enzyme (ACE) inhibitors. However, there is low awareness of enalapril/ACE inhibitor-induced an...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029729/ https://www.ncbi.nlm.nih.gov/pubmed/29974027 http://dx.doi.org/10.7759/cureus.2572 |
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author | Okumu, Mitchel Ochola, Francis Bodo, Calvin Apuoyo, Kevin Odhiambo, Nelson Ng'ong'a, Albert |
author_facet | Okumu, Mitchel Ochola, Francis Bodo, Calvin Apuoyo, Kevin Odhiambo, Nelson Ng'ong'a, Albert |
author_sort | Okumu, Mitchel |
collection | PubMed |
description | Tolerability, a good safety profile, affordability, and a preponderance to afford cardio-renal protection in patients with diabetes make enalapril one of the most commonly prescribed angiotensin-converting enzyme (ACE) inhibitors. However, there is low awareness of enalapril/ACE inhibitor-induced angioedema among medical personnel. This is because the diagnosis presents an ongoing challenge, particularly when the presentation is delayed following long-term therapy with ACE inhibitors. Here, we present two cases: a 58-year-old female and a 55-year-old male who presented to the outpatient department of Nyakach County Hospital, Pap Onditi village, Kenya, with progressive swelling of the face and upper and lower lips and stridor of 11 and 10 hours, respectively, after their usual dose of enalapril. Case 1 resolved following the administration of stat doses of intravenous (IV) hydrocortisone 200 mg and IV chlorpheniramine 20 mg as well as thrice daily peroral doses of chlorpheniramine 8 mg, and tapered peroral doses of prednisolone: 40 mg thrice daily for five days, 20 mg thrice daily for five days, 10 mg thrice daily for five days, and 5 mg thrice daily for five days. Case 2 resolved following the administration of a stat dose of IV dexamethasone, a twice daily peroral dose of cetrizine 10 mg, and tapered peroral doses of prednisolone: 20 mg thrice daily for five days, 10 mg thrice daily for five days, and 5 mg thrice daily for five days. |
format | Online Article Text |
id | pubmed-6029729 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-60297292018-07-04 Enalapril-Induced Angioedema: Two Case Reports in a Rural Health Facility in Kenya Okumu, Mitchel Ochola, Francis Bodo, Calvin Apuoyo, Kevin Odhiambo, Nelson Ng'ong'a, Albert Cureus Emergency Medicine Tolerability, a good safety profile, affordability, and a preponderance to afford cardio-renal protection in patients with diabetes make enalapril one of the most commonly prescribed angiotensin-converting enzyme (ACE) inhibitors. However, there is low awareness of enalapril/ACE inhibitor-induced angioedema among medical personnel. This is because the diagnosis presents an ongoing challenge, particularly when the presentation is delayed following long-term therapy with ACE inhibitors. Here, we present two cases: a 58-year-old female and a 55-year-old male who presented to the outpatient department of Nyakach County Hospital, Pap Onditi village, Kenya, with progressive swelling of the face and upper and lower lips and stridor of 11 and 10 hours, respectively, after their usual dose of enalapril. Case 1 resolved following the administration of stat doses of intravenous (IV) hydrocortisone 200 mg and IV chlorpheniramine 20 mg as well as thrice daily peroral doses of chlorpheniramine 8 mg, and tapered peroral doses of prednisolone: 40 mg thrice daily for five days, 20 mg thrice daily for five days, 10 mg thrice daily for five days, and 5 mg thrice daily for five days. Case 2 resolved following the administration of a stat dose of IV dexamethasone, a twice daily peroral dose of cetrizine 10 mg, and tapered peroral doses of prednisolone: 20 mg thrice daily for five days, 10 mg thrice daily for five days, and 5 mg thrice daily for five days. Cureus 2018-05-02 /pmc/articles/PMC6029729/ /pubmed/29974027 http://dx.doi.org/10.7759/cureus.2572 Text en Copyright © 2018, Okumu et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Emergency Medicine Okumu, Mitchel Ochola, Francis Bodo, Calvin Apuoyo, Kevin Odhiambo, Nelson Ng'ong'a, Albert Enalapril-Induced Angioedema: Two Case Reports in a Rural Health Facility in Kenya |
title | Enalapril-Induced Angioedema: Two Case Reports in a Rural Health Facility in Kenya |
title_full | Enalapril-Induced Angioedema: Two Case Reports in a Rural Health Facility in Kenya |
title_fullStr | Enalapril-Induced Angioedema: Two Case Reports in a Rural Health Facility in Kenya |
title_full_unstemmed | Enalapril-Induced Angioedema: Two Case Reports in a Rural Health Facility in Kenya |
title_short | Enalapril-Induced Angioedema: Two Case Reports in a Rural Health Facility in Kenya |
title_sort | enalapril-induced angioedema: two case reports in a rural health facility in kenya |
topic | Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029729/ https://www.ncbi.nlm.nih.gov/pubmed/29974027 http://dx.doi.org/10.7759/cureus.2572 |
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