Introduction. Angiotensin-converting enzyme inhibitors are leading cause of
drug-induced angioedema, with incidence of 0.1 to 0.2%. The angioedema is not
of immune nature; in predisposed individuals it is caused by accumulation of
vasoactive mediators due to reduced activity of angiotensinconverting enzyme.
Case report. We presented a 63-year old male patient suffering from
hypertension and chronic obstructive pulmonary disease, who had developed two
episodes of angioedema during a 5-year long therapy with enalapril. The first
episode happened after three, and the second after five years of the therapy.
On both occasions, the patient was admitted to the hospital and tracheotomy
was avoided in the last moment. Conclusion. Long-term therapy with
angiotensin-converting enzyme inhibitors could be associated with delayed
angioedema, especially in patients with inflammation of airways caused by
infection or chronic irritation.
Drug-Induced Cough
