Angio‐oedema induced by ACE inhibitors

Hypotensive reaction during staphylococcal protein A column therapy in a patient with anomalous degradation of bradykinin and Des‐Arg9‐bradykinin after contact activation

“…With this new kinetic approach to examining endogenous BK and Des‐Arg 9 ‐BK generation and degradation, our results confirm our previous observations of a prolonged t 50 of exogenously added kinins in a limited number of patients with low APP levels who experienced hypotensive reactions during hemodialysis and blood transfusions while taking ACE inhibitors 17,20 . The kinetic profiles of degradation of BK, and especially that of Des‐Arg 9 ‐BK, closely correlate with those recently reported for a group of patients who experienced ACE inhibitor‐associated angioedema 46‐48 . This similarity suggests the B 1 receptor agonist Des‐Arg 9 ‐BK may be important in the pathophysiology of these acute side effects associated with an ACE inhibitor.…”

Association between ACE Inhibitors and Acute Pancreatitis in the Elderly

“…Prior to 1994, there were >100 cases of acute pancreatitis associated with ACE inhibitors reported to the Food and Drug Administration (FDA) and various pharmaceutical companies. 5 Since then, several other cases have been reported. 4,5,7–9 Some described resolution after withdrawal and recurrence after rechallenge, 4,8,9 thus establishing a possible link between ACE inhibitors and pancreatitis.…”

“…5 Since then, several other cases have been reported. 4,5,7–9 Some described resolution after withdrawal and recurrence after rechallenge, 4,8,9 thus establishing a possible link between ACE inhibitors and pancreatitis. However, the mechanism involved remains unclear.…”

“…While some postulate that it is due to localized pancreatic angioedema with resultant ductal obstruction, others suggest that hypoglycemia associated with ACE inhibitors may have toxic effects on the pancreas. 4 At present, the clinical evidence of ACE inhibitor–induced pancreatitis is based on case reports 5–9 ; no epidemiologic studies have been identified. Due to the substantial morbidity and mortality of acute pancreatitis and the wide use of ACE inhibitors, more information is needed to better characterize the risk associated with these agents.…”