Visceral angioedema

ACE inhibitors are the leading cause of drug-induced angio-oedema in the USA. ACE inhibitor-induced intestinal angio-oedema, a much rarer complication of this medication, has been reported. The author reports a patient presenting with a 1-day history of severe abdominal pain. The patient was started on lisinopril 2 days prior to this presentation. Computer axial tomography (CAT) scan of the abdomen demonstrated extensive and marked thickening, and oedema involving the duodenum and proximal jejunum associated with significant mesenteric oedema...

Abdominal pain can be a challenging presenting complaint with a broad differential diagnosis. Medication side-effect must always be considered. Visceral angio-oedema secondary to angiotensin-converting enzyme inhibitor use can cause abdominal pain. The association of angiotensin-converting enzyme inhibitor and visceral angio-oedema is not well recognized partly because the onset of angio-oedema might be delayed for months or years after commencement of an angiotensin-converting enzyme inhibitor. The epidemiology of angio-oedema is now changing in parallel with the increasing use of angiotensin-converting enzyme inhibitors...

Angiotensin-converting enzyme (ACE) inhibitors are standard medication in treating hypertension, heart failure and diabetic nephropathy. The most common side effects are cough and angioneurotic oedema of the upper airways. A less familiar side effect is the ACE inhibition-induced visceral angioedema. We report the case of a young female patient with recent diagnosis of heart failure (dilated cardiomyopathy due to viral myocarditis), who developed angioedema of the small intestine three weeks after initiating treatment with lisinopril...

BACKGROUND: Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is an uncommon but serious hypersensitivity drug reaction most frequently associated with antiepileptics. Clinical manifestations include rash, fever, and visceral organ involvement, most commonly hepatitis. The mortality rate associated with DRESS syndrome is approximately 10%, the majority due to fulminant liver failure. OBJECTIVES: We report one case of phenytoin-induced DRESS syndrome in a patient who presented to the Emergency Department (ED)...

We report a case of a new diagnosis of hereditary angioedema (HAE) presenting with genital swelling to a genitourinary (GU) medicine clinic. There is often a significant delay in diagnosing HAE, but it commonly presents with genital swelling before manifesting as potentially life-threatening visceral attacks. This case highlights the fact that HAE should be considered as an important differential diagnosis of genital oedema, as early recognition may help to prevent more serious future visceral episodes.

Visceral angioedema is an uncommon but serious complication of therapy with angiotensin-converting enzyme (ACE) inhibitors. We report a case, review the literature, and discuss the incidence, features, and clinical recognition of this condition.

OBJECTIVE: Our objectives are to describe the CT features of angiotensin-converting enzyme (ACE) inhibitor-induced visceral angioedema and to review other conditions that may have similar findings. CONCLUSION: CT findings in a patient taking an angiotensin-converting enzyme (ACE) inhibitor help in the diagnosis and subsequent treatment of ACE inhibitor-induced visceral angioedema.

Hereditary angioedema (HAE) is a rare but important disease because of the occurrence of life-threatening symptoms during attacks as well as due to diagnostic and therapeutic problems. Deficiency or absence of plasma protein--C1 esterase inhibitor is autosomal dominant condition and is connected with uncontrolled complement and contact systems activation which leads to the generation of vasoactive mediators, most likely bradykinin. The main syndromes are recurrent attacks of localized swelling of submucosal and subcutaneous tissue, or both...

Hereditary angioedema (HAE) is a rare condition known to cause episodic, self-limiting, nonpruritic, nonpitting edema that involves skin and visceral organs. It may affect any external body surface including face, extremities, and genitalia. Most commonly involved viscera are gastrointestinal and respiratory systems. Patients may have severe abdominal pain because of edema of the bowel wall. This disease can cause life threatening laryngeal edema if it involves the airway.We describe a patient with HAE who was initially diagnosed with arthritis after she had recurrent edema around her peripheral joints...

Angioedema remains a rare but potentially life-threatening complication of angiotensin-converting enzyme (ACE) inhibitor use. Most presentations involve edema of the tongue or oral pharynx. However, in recent years, a visceral form involving the gastrointestinal tract also has been described. We present the case of a rare presentation of esophageal and retropharyngeal edema related to ACE inhibitor use. A review of ACE inhibitor-related angioedema is also presented.

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Hereditary angioedema is a congenital disorder with recurrent attacks of localized swelling of submucosal and subcutaneous tissue, or both caused by a deficiency of the plasma protein C1 inhibitor. It is caused by heterozygous defects in the C1 inhibitor gene located on chromosome 11q, and it has an autosomal dominant inheritance pattern. This disease afflicts 1 in 10,000 to 1 in 150,000 persons. Hereditary angioedema has been reported in all races, and no sex predominance has been found. Skin and visceral organs may be involved by the typically massive local edema...

A 44-year-old woman on maintenance hemodialysis was admitted to our hospital because of severe abdominal pain. The patient had been medicated with lisinopril and valsartan for hypertension for one month prior to admission. An abdominal computerized scan (CT) showed a dilated and thickened loop of the small bowel with massive ascites and a small nodule in the jejunum. The patient's abdominal pain was thought to be due to isolated visceral angioneurotic edema induced by lisinopril and/or valsartan, and medication of these two drugs was therefore stopped...

OBJECTIVE: To describe a case of intermittent visceral angioedema associated with long-term enalapril use. CASE SUMMARY: A 72-year-old white woman developed severe abdominal pain as a result of visceral angioedema associated with long-term enalapril therapy. She had been taking enalapril 20 mg/day for 9 years prior to the first reported episodes of abdominal pain. DISCUSSION: Visceral angioedema associated with angiotensin-converting enzyme (ACE) inhibitors is a documented adverse effect...

Idiopathic anaphylaxis (IA) has been described as a clinical entity by North America authors. The symptoms are brisk and relapsing episodes of angioedema, urticaria, bronchospasm, digestive symptoms, cardio-vascular collapse. Adults, females more than males, are mainly concerned. The seriousness is linked to laryngeal angioedema or to hypotension. Nevertheless lethality is rare. The first step of the procedure is aimed at the detection of several rare pathologies mimicking IA: the paroxystic capillary leak syndrome induced by a monoclonal gammapathy or by a release of cytokines, a carcinoid syndrome, cutaneous or visceral mastocytosis, hereditary or acquired deficiency of C1 esterase inhibitor, relapsing benign flushes and factitious anaphylaxis...

Isolated visceral angioedema is an extremely rare complication of angiotensin-converting enzyme inhibitors (ACEIs). We report the first known case of ACEI-associated visceral angioedema occurring in a liver transplant recipient who presented with acute-onset abdominal pain, nausea, vomiting, diarrhea, radiologic findings of small bowel edema, and ascites. Heightened awareness of the phenomenon of isolated ACEI-associated visceral angioedema is necessary given the increasing use of these medications for treating hypertension related to calcineurin inhibitors and the need to avoid unnecessary surgical or diagnostic interventions in solid-organ transplant recipients...

Visceral angioedema is a rare complication of angiotensin-converting enzyme (ACE) inhibitor use. To date, 15 cases have been reported in the literature. Common presentation is that of a middle-aged woman with abdominal pain, emesis, and diarrhea who has recently begun taking an ACE inhibitor. Signs include leukocytosis, ascites, and edematous small bowel seen on computed tomography. Diagnosis is elusive, and frequently invasive procedures, including surgery, are pursued. These can be avoided if the astute physician recognizes the association and withdraws the offending medication...

Hereditary angioedema (HAE) is an autosomal dominant disease that afflicts 1 in 10,000 to 1 in 150,000 persons; HAE has been reported in all races, and no sex predominance has been found. It manifests as recurrent attacks of intense, massive, localized edema without concomitant pruritus, often resulting from one of several known triggers. However, attacks can occur in the absence of any identifiable initiating event. Historically, 2 types of HAE have been described. However, a variant, possibly X-linked, inherited angioedema has recently been described, and tentatively it has been named "type 3" HAE...

OBJECTIVE: The purpose of this study was to determine the added diagnostic value of CT for the diagnosis of visceral angioedema. CONCLUSION: Thickening of the small-bowel wall and mucosa with increased contrast enhancement, depiction of more layers of the small-bowel wall than normal, prominent mesenteric vessels, ascites, and fluid accumulation in the small bowel or together in the small bowel and the colon were the most significant CT findings in three patients with visceral angioedema...

We experienced two cases of limb edema of unknown pathogenesis. No evidence was found concerning involvement of the kidneys, heart of other visceral organs. Case 1 was 22-year-old woman. Her white blood cell count increased to 13,100/microliter with 65.0% eosinophils. Case 2 was a 27-year-old woman. Her white blood cell count increased to 23,300/microliter with 67.0% eosinophils. In these cases, extensive diagnostic evaluations revealed no evidence of atopy, neoplasms, collagen-vascular disease, or parasitic infestation...