Fresh frozen plasma for progressive and refractory angiotensin-converting enzyme inhibitor-induced angioedema

J Emerg Med. 2013 Apr;44(4):764-72. doi: 10.1016/j.jemermed.2012.07.055. Epub 2012 Oct 28.

Abstract

Background: Angioedema secondary to angiotensin-converting enzyme inhibitors (ACEI) is a commonly encountered problem in the Emergency Department (ED). The treatment of ACEI-induced edema with conventional methods such as epinephrine, steroids, and antihistamines is usually not effective. There is limited experience using bradykinin receptor blockers and fresh frozen plasma (FFP) as a treatment modality for ACEI-induced angioedema.

Objective: To emphasize alternative treatment option for ACEI-induced angioedema in the ED.

Case reports: We report a case series of progressive and refractory presumed ACEI-induced angioedema that all improved in temporal association with administration of FFP, with a brief review of the literature.

Conclusion: There was a temporal association between the administration of FFP and improvement in angioedema in seven cases of presumed ACEI-induced angioedema that were refractory to antihistamines, corticosteroids, and epinephrine.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Angioedema / chemically induced
  • Angioedema / drug therapy*
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects*
  • Blood Transfusion / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Plasma*
  • Treatment Outcome

Substances

  • Angiotensin-Converting Enzyme Inhibitors