BRIEF REPORT Angioedema After Local Trauma in a Patient on Angiotensin-Converting Enzyme Inhibitor Therapy

Angioedema is a side effect that is often associated with the use of angiotensin-converting enzyme (ACE) inhibitor medications. These medications result in increased levels of circulating bradykinins. This case illustrates the result of a local traumatic event to the upper lip, presumably causing marked bradykinin release in a patient who was taking an ACE inhibitor. The local release of bradykinin from trauma, in addition to decreased bradykinin catabolism secondary to ACE inhibitor therapy, resulted in angio-edema predominantly in the upper lip. The angioedema resolved with discontinuation of the ACE inhibi-tor. (J Am Board Fam Med 2008;21:577–9.) As the indications and usage of angiotensin-con-verting enzyme (ACE) inhibitor therapy increases, one of its potential side effects, angioedema, is becoming commonly encountered in primary care. Angioedema is a potentially life-threatening side effect of ACE inhibitor therapy, which has an es-timated incidence of 0.1 % up to 6%.1 Angioedema resulting secondary to ACE inhibitor use may oc