I'm grateful to William Smith and Andrew Whyte for sharing their Adelaide experience with this problem:
William Smith expands: "We have not seen a direct death from ACE-I angioedema. (Unfortunately we had a recent death from HAE). However several years ago a patient died at the RAH from multi-organ ICU syndrome after prolonged intubation for ACE-I induced angioedema, therefore an indirect death. This patient was reported by a general physician colleague (see attached). This occurred more than 10 years ago, we were not involved. We have had 3 intubations for this in the past 4 months or so- things always seem to come in runs- we didn't get in with the icatibant soon enough to prevent the tube. Regards William"
William kindly attached a useful overview of ACE-associated angioedema
From Andrew: "William Smith tells me that there was one patient at the RAH who was intubated for 2-3 days before we were consulted. They died from ventilator/hospital-acquired pneumonia, but not from the ACEI AE itself. So it might qualify, although indirectly – Andrew Whyte"
William Smith expands: "We have not seen a direct death from ACE-I angioedema. (Unfortunately we had a recent death from HAE). However several years ago a patient died at the RAH from multi-organ ICU syndrome after prolonged intubation for ACE-I induced angioedema, therefore an indirect death. This patient was reported by a general physician colleague (see attached). This occurred more than 10 years ago, we were not involved. We have had 3 intubations for this in the past 4 months or so- things always seem to come in runs- we didn't get in with the icatibant soon enough to prevent the tube. Regards William"
William kindly attached a useful overview of ACE-associated angioedema
(visit Immunology Readings page: article listed under "Angioedema" section)
