Lisinopril-Induced Small Bowel Angioedema: An Unusual Cause of Severe Abdominal Pain

Brooks W. Johnson; Ann M. Rydburg; Viet D. Do

doi:10.12659/AJCR.937895

22 November 2022 : Case report USA

Lisinopril-Induced Small Bowel Angioedema: An Unusual Cause of Severe Abdominal Pain

Challenging differential diagnosis, Unexpected drug reaction, Rare disease

Brooks W. Johnson

^1ABCDEFG*, Ann M. Rydburg^2ABDE, Viet D. Do^3ABE

DOI: 10.12659/AJCR.937895

Am J Case Rep 2022; 23:e937895

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Table 1. Summary of available, published reports of isolated small bowel angioedema.

Sex	Age	Race/ethnicity	Recent change in dose (Y/N)	Time on ACE-i	Medication and dose	Comorbid medical conditions	Concomitant medications	Clinical course and outcomes	Reference
F	40	White	No	3 days	Lisinopril, 20 mg qd	IBS, hypertension	Oral contraceptive	Resolution w/in 1 week of discontinuation	Squillante []⁵
F	62	African American	No	2 years	Lisinopril, 40 mg BID	Hypertension, a fib, DM2, seizure, anemia, COPD, temporal arteritis, GERD		N/A	Wilin []⁶
F	69	Asian	No	4 years	Perindopril	Hypertension, IgA nephropathy, lipid metabolism abnormality, cholelithiasis	Pitavastatin	Resolution	Nakano []⁷
F	44	White	No	1 hour	Perindopril, 4 mg daily	Hypertension		Resolution in 3 days	Huynh []⁸
F	28	N/A	No	2 months	Lisinopril	Hypertension	Oral contraceptive	Resolution in 2 days	Ferreira []⁹
F	32	White	No	1 month	Perindopril, 4 mg daily	Hypertension	metoprolol	Laparoscopy, 1 month delay in diagnosis	Parreira []¹⁰
M	53	n/a	No	7 years	Lisinopril	Hypertension, diverticulitis	Hydro-chlorothiazide	Resolution in 2 days of discontinuation, restarted on lisinopril post-hospitalization then d/c’d by primary care	Melendez []¹¹
F	N/A	N/A	No	3 weeks	Lisinopril	Myocarditis, heart failure		Resolution within days of discontinuation	Cuypers []¹²
F	72	N/A	Yes, 10–20 mg daily	1 month	Lisinopril, 20 mg daily	Hypertension			Chase []¹³
F	48	Asian	No	2 days	Captopril	Hypertension		Continued on Captopril, later developed oropharyngeal angioedema	Matsumura []¹⁴
F	58	N/A	n/a	1 week	Lisinopril	Hypertension		Resolution in 24 hours of discontinuation	Gregory []¹⁵
F	41	White	No	2 days	Lisinopril 5 mg daily	Hypertension		Delayed in diagnosis with multiple hospitalizations, resolution 48hr after discontinuation	Abdelmalek []¹⁶
F	59	N/A	n/a	2 days	Enalapril	Hypertension		5-year delay in diagnosis, resolution with discontinuation	Mullins []¹⁷
F	29	N/A	n/a	4 months	Lisinopril	Hypertension			Guy []¹⁸

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Lisinopril-Induced Small Bowel Angioedema: An Unusual Cause of Severe Abdominal Pain

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