Risk of angioedema in transplant recipients on ACE inhibitors
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Risk of angioedema in transplant recipients on ACE inhibitors Transplant recipients who receive an ACE inhibitor are at increased risk of developing angioedema, conclude US-based researchers. They propose that "the effect of immunosuppressant agents on [dipeptidyl peptidase IV] activity contributes to this increased risk". To test the hypothesis that transplant patients are at increased risk for ACE inhibitor-associated angioedema, the researchers examined data for 145 cases with ACE inhibitor-associated angioedema and 280 ACE-inhibitorexposed controls. They found that transplant patients were "significantly overrepresented" among ACE inhibitorassociated angioedema cases versus controls (OR 18.5; 95% CI 2.3, 147.2, p = 0.0004). Univariate analysis revealed that chronic renal failure, immunosuppressant use, smoking and seasonal allergies were also associated with ACE inhibitorassociated angioedema. However, in multivariate analysis, the association of transplant status and ACE-inhibitor-associated angioedema "was no longer significant", say the researchers. They did find that dipeptidyl peptidase IV activity was significantly decreased in sera derived from cases, and in individuals taking immunosuppressants, compared with ACE inhibitor-exposed controls. Byrd JB, et al. Association of angiotensin-converting enzyme inhibitor-associated angioedema with transplant and immunosuppressant use. Allergy : 14 Jun 2010. Available from: URL: http://dx.doi.org/10.1111/ 803028089 j.1398-9995.2010.02398.x
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Reactions 31 Jul 2010 No. 1312
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