Why the study?
Cases of ACE inhibitor-induced angioedema involving the concurrent use of other medications are less explored.
Concurrent use of ACE inhibitors with DPP-IV inhibitors and calcium channel blockers may increase the risk of bradykinin-mediated angioedema, which can be misdiagnosed as a contrast allergy if temporally related to contrast administration.
May prompt consideration of medication-induced angioedema over contrast allergy in ACE inhibitor users; hypothesis-generating for exacerbation by DPP-IV inhibitors, CCBs, and NSAIDs.
Angioedema is a rare but potentially life-threatening complication associated with angiotensin-converting enzyme (ACE) inhibitors. Although the pathophysiology is well understood, cases involving the concurrent use of other medications are less explored. We present a unique case of ACE inhibitor-induced angioedema in a 57-year-old male, which developed soon after receiving intravenous contrast. The patient's medication list included a dipeptidyl peptidase-IV inhibitor and a calcium channel blocker. Studies have shown an increased risk of angioedema with the combined use of these medications, likely due to alterations in bradykinin metabolism. This case highlights the importance of medication review and consideration of potential drug interactions when prescribing ACE inhibitors. It emphasizes the significance of diagnostic accuracy to avoid the mislabeling of allergies and consideration of other etiologies in angioedema. Healthcare providers ought to be mindful of the increased risk of angioedema when prescribing dipeptidyl peptidase-IV inhibitors and calcium-channel blockers with ACE inhibitors, as these are frequently used medications.
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Lepore et al. (2023) studied this question.
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