首次服用血管紧张素转换酶抑制剂后出现危及生命的血管性水肿——并非过敏反应。
Life-threatening angio-oedema after the first dose of an ACE inhibitor-not an anaphylactic reaction.
作者信息
Krogh Nielsen Troels, Bygum Anette, Rye Rasmussen Eva
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Denmark.
Dermatology and Allergy Center, University Hospital of Odense, Odense, Denmark.
出版信息
BMJ Case Rep. 2016 May 26;2016:bcr2016214364. doi: 10.1136/bcr-2016-214364.
We present a case of a 60-year-old Caucasian woman, with no prior history of swellings, who was admitted to a hospital due to life-threatening angio-oedema. She had, the previous day, been prescribed an ACE inhibitor for her essential hypertension. She had taken one tablet at night-time, and awoke in the morning with a swollen face progressing to involve the tongue and throat within a few hours. On arrival at her doctor's office, her voice had altered. Corticosteroids and antihistamine were administered while awaiting an ambulance. Arriving at the emergency department, she had dyspnoea due to increasingly severe angio-oedema of the upper airways. Neither adrenaline inhalations, intravenously administrated corticosteroids, atropine nor furosemide were effective and the patient soon become bradycardic. A tracheotomy was performed and the patient was placed on a ventilator. She eventually made a full recovery. It was concluded that she had suffered from life-threatening angio-oedema due to her new medication.
我们报告一例60岁的白种女性病例，该患者既往无肿胀病史，因危及生命的血管性水肿入院。前一天，她因原发性高血压开始服用一种血管紧张素转换酶（ACE）抑制剂。她在夜间服用了一片药，早上醒来时面部肿胀，几小时内发展至累及舌头和咽喉。到达医生办公室时，她的声音已经改变。在等待救护车期间，给予了皮质类固醇和抗组胺药。到达急诊科时，由于上呼吸道血管性水肿日益严重，她出现了呼吸困难。肾上腺素吸入、静脉注射皮质类固醇、阿托品和呋塞米均无效，患者很快出现心动过缓。遂进行了气管切开术，并将患者置于呼吸机上。她最终完全康复。结论是她因新服用的药物患上了危及生命的血管性水肿。
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