enalapril and Lip-Diseases

Topics: Algorithms; Anaphylaxis; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Diagnosis, Differential; Enalapril; Humans; Hypertension; Lip Diseases; Male; Middle Aged; Recurrence; Tongue Diseases

The following case reports describe the clinical presentation, diagnosis and management of two patients who attended Liverpool University Dental Hospital with rapidly increasing swelling of the lips and tongue. Both patients were suffering from angioedema and were taking an angiotension-converting enzyme (ACE) inhibitor (ACEI). A provisional diagnosis of ACEI-induced angioedema was made. An intramuscular injection of chlorpheniramine maleate was given to both patients and they were immediately transferred to the local accident and emergency department. These cases illustrate the potential role of the general dental practitioner in the early recognition and management of this potentially life-threatening condition.

Topics: Aged; Angioedema; Angiotensin-Converting Enzyme Inhibitors; Chlorpheniramine; Enalapril; Histamine H1 Antagonists; Humans; Lip Diseases; Male; Perindopril; Tongue Diseases

A review of two cases of angioedema associated with therapeutic doses of the angiotensin-converting enzyme inhibitor enalapril are presented along with a review of the relevant literature. Although angioedema of the facial and oral pharyngeal regions is a relatively rare occurrence with the use of ACE inhibitors, recognition of these agents as the cause of such a condition, when subacute, can lead to a rapid cure. Knowledge of these effects may also be helpful in the management of an acute clinical manifestation and, as importantly, may help prevent a recurrent episode due to the ill-guided continuation of the drug.

Topics: Adult; Angioedema; Enalapril; Humans; Lip Diseases; Male; Middle Aged