Bradykinin-Mediated Angioedema Associated with ACE Inhibitor, Managed with C1 Esterase Inhibitor

Abstract

Introduction: Bradykinin-mediated angioedema is a rare clinical condition that can present diagnostic challenges, particularly when it occurs independently of C1 esterase inhibitor activity. One of the most common triggers is angiotensin-converting enzyme (ACE) inhibitors, which can lead to edema by preventing the breakdown of bradykinin. Case Presentation: A 70-year-old male patient, using an ACE inhibitor for hypertension, presented to the emergency department with tongue swelling after receiving cisplatin-docetaxel-5 fluorouracil treatment for laryngeal cancer. His symptoms did not improve with anti-allergic treatment, but showed rapid resolution following administration of C1 esterase inhibitor. Discussion: This case presents a bradykinin-mediated angioedema episode associated with ACE inhibitor use, which responded to C1 esterase inhibitor treatment. Clinicians should consider C1 esterase inhibitor therapy in cases unresponsive to standard allergy treatments.

Keywords

• Bradykinin
• ACE inhibitor
• Angioedema
• C1 esterase inhibitor

C1 Esteraz İnhibitörü ile Tedavi Edilen ACE İnhibitörü ile İlişkili Bradikinin Aracılıklı Anjiyoödem

Abstract

Giriş: Bradikinin aracılı anjiyoödem, özellikle C1 esteraz inhibitör aktivitesinden bağımsız olarak ortaya çıktığında tanısal zorluklara yol açabilen nadir bir klinik durumdur. En yaygın tetikleyicilerden biri, bradikininin parçalanmasını engelleyerek ödeme neden olabilen anjiyotensin dönüştürücü enzim (ACE) inhibitörleridir. Olgu Sunumu: Hipertansiyon nedeniyle ACE inhibitörü kullanan 70 yaşında bir erkek hasta, larenks kanseri için sisplatin-dosetaksel-5 florourasil tedavisi aldıktan sonra dilinde şişme şikayetiyle acil servise başvurdu. Hastanın semptomları antialerjik tedavi ile iyileşmedi, ancak C1 esteraz inhibitörü uygulamasından sonra hızla düzeldi. Tartışma: Bu olgu sunumunda, ACE inhibitörü kullanımına bağlı ve C1 esteraz inhibitörü tedavisine yanıt veren bradikinin aracılı anjiyoödem atağı sunulmaktadır. Klinisyenler, standart alerji tedavilerine yanıt vermeyen vakalarda C1 esteraz inhibitörü tedavisini düşünmelidir.

Keywords

• Bradikinin
• ACE inhibitörü
• Anjiyoödem
• C1 esteraz inhibitörü

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