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Perindopril-induced angioedema of the lips and tongue: a case report

BACKGROUND: Ace inhibitor-induced angioedema, characterized by sudden-onset swelling of the mucous membrane, skin, or both, is a rare occurrence in the Kingdom of Saudi Arabia. Because of its safety and efficacy, perindopril is a commonly prescribed angiotensin-converting enzyme inhibitor. Here we d...

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Autores principales: Alharbi, Fawaz Abdullah, Alharthi, Abdulwahab Awadh, Alsaadi, Faisal Nuefa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280524/
https://www.ncbi.nlm.nih.gov/pubmed/30514395
http://dx.doi.org/10.1186/s13256-018-1910-x
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author Alharbi, Fawaz Abdullah
Alharthi, Abdulwahab Awadh
Alsaadi, Faisal Nuefa
author_facet Alharbi, Fawaz Abdullah
Alharthi, Abdulwahab Awadh
Alsaadi, Faisal Nuefa
author_sort Alharbi, Fawaz Abdullah
collection PubMed
description BACKGROUND: Ace inhibitor-induced angioedema, characterized by sudden-onset swelling of the mucous membrane, skin, or both, is a rare occurrence in the Kingdom of Saudi Arabia. Because of its safety and efficacy, perindopril is a commonly prescribed angiotensin-converting enzyme inhibitor. Here we describe the clinical manifestations, management, and outcome of perindopril-induced angioedema of the lips and tongue in a 65-year-old Saudi man. CASE PRESENTATION: A 65-year-old Saudi Arab man presented to an emergency department with lip and tongue swelling and dysphagia. There were no systemic symptoms and no past history of a similar event. He had been consuming perindopril 5 mg and amlodipine 5 mg for the last 3 weeks: brand name, Coveram, from the company Servier (Ireland) Industries Ltd.; one tablet of Coveram contains 3.395 mg perindopril corresponding to 5 mg perindopril arginine and 6.935 mg amlodipine besilate corresponding to 5 mg amlodipine. A physical examination revealed considerable swelling of his lips and tongue. Examinations of other systems, including his cardiovascular and respiratory systems, revealed unremarkable findings. All laboratory parameters were also normal. Electrocardiography demonstrated sinus rhythm, a normal P axis, and V-rate of 50–99. A clinical diagnosis of perindopril-induced angioedema was made, and perindopril was discontinued. The angioedema resolved completely after the administration of antihistamines and corticosteroids. CONCLUSIONS: Angioedema caused by angiotensin-converting enzyme inhibitors is an uncommon occurrence in Saudi Arabia. The findings from this case are expected to raise awareness about this condition among clinicians in this country.
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spelling pubmed-62805242018-12-10 Perindopril-induced angioedema of the lips and tongue: a case report Alharbi, Fawaz Abdullah Alharthi, Abdulwahab Awadh Alsaadi, Faisal Nuefa J Med Case Rep Case Report BACKGROUND: Ace inhibitor-induced angioedema, characterized by sudden-onset swelling of the mucous membrane, skin, or both, is a rare occurrence in the Kingdom of Saudi Arabia. Because of its safety and efficacy, perindopril is a commonly prescribed angiotensin-converting enzyme inhibitor. Here we describe the clinical manifestations, management, and outcome of perindopril-induced angioedema of the lips and tongue in a 65-year-old Saudi man. CASE PRESENTATION: A 65-year-old Saudi Arab man presented to an emergency department with lip and tongue swelling and dysphagia. There were no systemic symptoms and no past history of a similar event. He had been consuming perindopril 5 mg and amlodipine 5 mg for the last 3 weeks: brand name, Coveram, from the company Servier (Ireland) Industries Ltd.; one tablet of Coveram contains 3.395 mg perindopril corresponding to 5 mg perindopril arginine and 6.935 mg amlodipine besilate corresponding to 5 mg amlodipine. A physical examination revealed considerable swelling of his lips and tongue. Examinations of other systems, including his cardiovascular and respiratory systems, revealed unremarkable findings. All laboratory parameters were also normal. Electrocardiography demonstrated sinus rhythm, a normal P axis, and V-rate of 50–99. A clinical diagnosis of perindopril-induced angioedema was made, and perindopril was discontinued. The angioedema resolved completely after the administration of antihistamines and corticosteroids. CONCLUSIONS: Angioedema caused by angiotensin-converting enzyme inhibitors is an uncommon occurrence in Saudi Arabia. The findings from this case are expected to raise awareness about this condition among clinicians in this country. BioMed Central 2018-12-05 /pmc/articles/PMC6280524/ /pubmed/30514395 http://dx.doi.org/10.1186/s13256-018-1910-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Alharbi, Fawaz Abdullah
Alharthi, Abdulwahab Awadh
Alsaadi, Faisal Nuefa
Perindopril-induced angioedema of the lips and tongue: a case report
title Perindopril-induced angioedema of the lips and tongue: a case report
title_full Perindopril-induced angioedema of the lips and tongue: a case report
title_fullStr Perindopril-induced angioedema of the lips and tongue: a case report
title_full_unstemmed Perindopril-induced angioedema of the lips and tongue: a case report
title_short Perindopril-induced angioedema of the lips and tongue: a case report
title_sort perindopril-induced angioedema of the lips and tongue: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280524/
https://www.ncbi.nlm.nih.gov/pubmed/30514395
http://dx.doi.org/10.1186/s13256-018-1910-x
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