Authors

    Language

    English

    Publication Date

    1-1-2020

    Journal

    TH Open

    DOI

    10.1055/s-0040-1701238

    PMID

    31984307

    PMCID

    PMC6978173

    PubMedCentral® Posted Date

    1-23-2020

    PubMedCentral® Full Text Version

    Post-print

    Abstract

    Angiotensin-converting enzyme (ACE) inhibitors are extensively prescribed to treat patients with hypertension, congestive heart failure, and diabetic nephropathy. A small fraction of these patients (approximately 0.7%) develop angioedema, manifested by swelling of the lips and oropharynx. Angioedema of oropharynx is a medical emergency that can lead to asphyxiation and death. The angioedema is due to bradykinin generated from high molecular weight kininogen by kallikrein, which is derived from plasma prekallikrein by action of the factor XIIa, factor Xia, or prolylcarboxypeptidase. Bradykinin induces vasodilation and increased vascular permeability. ACE is the major degrading enzyme of bradykinin in the intravascular department. ACE inhibitors inhibit the proteolytic inactivation of bradykinin. We report a patient with oropharyngeal angioedema associated with an ACE inhibitor with complete absence of plasma prekallikrein due to homozygous mutation (Ser97PhefsTer173).

    Keywords

    bradykinin, prekallikrein, kininogen

    Published Open-Access

    yes

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