enalapril and Arthritis--Rheumatoid

Topics: Arthritis, Rheumatoid; Blood Pressure; Drug Interactions; Enalapril; Felodipine; Female; Humans; Hypertension; Indomethacin; Male; Middle Aged; Osteoarthritis

75% of patients systematically taking over the period of 6 weeks nonsteroidal anti-inflammatory drugs have their mucous of gastrointestinal tract pathologically changed. This process is called induced NSAID gastropathy. Inhibitors of angiotensin converting enzyme (I-ACE) seems to have gastroprotective effect by enhancing level of endogenous prostaglandins. Besides, an application of I-ACE reduces angiotensin II formation and activates renin-kallicrein-kinin system resulting in nitrogen oxide formation that is in its turn an important component of reparative process of mucous of gastrointestinal tract.

Topics: Angiotensin-Converting Enzyme Inhibitors; Animals; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Captopril; Disease Models, Animal; Enalapril; Gastric Mucosa; Indomethacin; Lisinopril; Male; Rats; Stomach Ulcer; Treatment Outcome

Topics: Angiotensin-Converting Enzyme Inhibitors; Antirheumatic Agents; Arthritis, Rheumatoid; Drug Synergism; Enalapril; Gold Sodium Thiomalate; Humans; Male; Middle Aged; Vasomotor System

The inappropriate use of antihypertensive medications may cause hypotensive responses associated with organ failure. We describe a patient who developed nonocclusive splanchnic ischemia leading to death following the administration of enalapril to treat postoperative hypertension. The mechanisms and consequences of refractory hypotension induced by angiotensin-converting enzyme inhibitors are discussed.

Topics: Aged; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Arthritis, Rheumatoid; Colon; Enalapril; Fatal Outcome; Female; Humans; Hypertension; Ischemia; Multiple Organ Failure; Necrosis; Postoperative Complications; Splanchnic Circulation

We report a case of vasculitis in a 67-year-old woman who successively developed over a four-month period clinical manifestations suggestive of rheumatoid arthritis, lupus, sicca, syndrome and finally giant cell arteritis. All her symptoms resolved promptly upon discontinuation of enalapril and none recurred over the five-year follow-up period. The only residual manifestation is Jaccoud's arthropathy of the hands.

Topics: Aged; Antihypertensive Agents; Arthritis, Rheumatoid; Diagnosis, Differential; Enalapril; Female; Follow-Up Studies; Giant Cell Arteritis; Hand; Humans; Lupus Vulgaris; Sjogren's Syndrome; Vasculitis

Topics: Angiotensin-Converting Enzyme Inhibitors; Arthritis, Rheumatoid; Dipeptides; Enalapril; Humans