Adam Mohammad, Tselovalnikova Tatiana, Evans Aron
Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO.
Department of Internal Medicine, Gastroenterology Section, University of Missouri-Kansas City School of Medicine, Kansas City, MO.
ACG Case Rep J. 2025 Feb 1;12(2):e01608. doi: 10.14309/crj.0000000000001608. eCollection 2025 Feb.
Angiotensin-converting enzyme inhibitors are a common cause of drug-induced angioedema, which rarely affects the gut. We present a 32-year-old White woman with Crohn's disease on lisinopril experiencing 1 year of episodic abdominal pain, nausea, and vomiting, prompting multiple steroid tapers and a switch in biologic therapy. She was hospitalized and was profoundly hypotensive on arrival. Initial imaging showed marked small bowel wall thickening and free fluid in the abdomen. She had rapid symptomatic and radiographic improvement after only 24 hours and was diagnosed with angiotensin-converting enzyme inhibitor-induced intestinal angioedema, an important Crohn's disease mimicker that may lead to unwanted management if unrecognized.
血管紧张素转换酶抑制剂是药物性血管性水肿的常见病因,很少累及肠道。我们报告一名32岁患克罗恩病的白人女性,服用赖诺普利后出现了1年的间歇性腹痛、恶心和呕吐,为此多次逐渐减少类固醇用量并更换生物治疗药物。她住院了,入院时血压极低。初始影像学检查显示小肠壁明显增厚且腹腔内有游离液体。仅24小时后,她的症状和影像学表现就迅速改善,并被诊断为血管紧张素转换酶抑制剂诱发的肠道血管性水肿,这是一种重要的可酷似克罗恩病的病症,如果未被识别可能会导致不必要的治疗。