与咪达普利和双氯芬酸相关的复发性严重血管性水肿。
Recurrent severe angioedema associated with imidapril and diclofenac.
作者信息
Kampitak Thatchai
机构信息
Department of Internal Medicine, Chulalongkorn University Hospital, Bangkok, Thailand.
出版信息
Allergol Int. 2008 Dec;57(4):441-3. doi: 10.2332/allergolint.C-08-61. Epub 2008 Nov 1.
BACKGROUND
Angioedema due to angiotensin-converting enzyme inhibitors (ACEIs) therapy occurs not infrequently and is sometimes associated with life-threatening conditions.
CASE SUMMARY
A 59-year-old woman presented with recurrent angioedema of the tongue complicated by upper airway obstruction which required endotracheal intubation. Laboratory tests including complement levels were normal. ACEI-associated angioedema precipitated by NSAIDs was suspected. Her condition improved after discontinuation of imidapril and diclofenac without other specific treatment.
DISCUSSION
ACEIs, and in particular concomitant use with NSAIDs, should be avoided in patients with a history of angioedema because continuing administration tends to lead to more severe attacks.
背景
血管紧张素转换酶抑制剂（ACEI）治疗引起的血管性水肿并不罕见，有时会伴有危及生命的情况。
病例摘要
一名59岁女性出现反复的舌血管性水肿，并伴有上呼吸道梗阻，需要进行气管插管。包括补体水平在内的实验室检查结果正常。怀疑是非甾体抗炎药（NSAIDs）诱发的ACEI相关性血管性水肿。停用咪达普利和双氯芬酸后，未进行其他特殊治疗，她的病情有所改善。
讨论
有血管性水肿病史的患者应避免使用ACEI，尤其是与NSAIDs同时使用，因为继续用药往往会导致更严重的发作。
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