[ACE-inhibitor-induced angioedema. The most frequent cause of oropharyngeal edema].

Angiotensin-converting enzyme (ACE) inhibitor-induced angioedema is supposed to be an uncommon cause for oropharyngeal edema. Between January 1, 1993 and February 1, 1997 we treated 20 patients with edema of the oropharyngeal region that was not caused by infection or irradiation. The most common reason was an ACE-inhibitor-induced angioedema and occurred in 9 cases, all of whom required inpatient treatment. The medical management consisted of the administration of intravenous (i.v.) glucocorticosteroids in all cases, H1-blockers in 6 cases, epinephrine by inhalation in one case and i.v. epinephrine in another case. Tracheostomy had to be performed in one patient. In our experience it is necessary to reconsider ACE inhibitor-induced angioedema in any case of an oropharyngeal edema. However, there is no reason for the routine application of epinephrine in these cases.