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Two cases of severe angio-oedema and rationale for their response to icatibant
  1. Oluwaseun O Akinduro1,
  2. Vishal Patel2,
  3. Tommy Thomas3,
  4. Faiz U Ahmad4
  1. 1Morehouse School of Medicine, Atlanta, Georgia, USA
  2. 2Emory School of Medicine, Atlanta, Georgia, USA
  3. 3Department of Neurology, Emory School of Medicine, Atlanta, Georgia, USA
  4. 4Emory University, Atlanta, Georgia, USA
  1. Correspondence to Dr Faiz U Ahmad, faiz.ahmad{at}

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First case: A 66-year-old woman presented to the emergency department (ED) with progressively worsening shortness of breath and mild swelling of her lips. Her home medications included simvastatin, lisinopril, esomeprazole, aspirin, metoprolol and hydrochlorothiazide. Soon after admission to the intensive case unit (ICU), she was given a single dose of lisinopril, which caused her lip swelling to worsen (figure 1A). She was started on methylprednisolone and diphenhydramine with no response. She was then given a dose of icatibant, a bradykinin B2 receptor antagonist, with complete resolution of the swelling within 24 h of administration (figure 1B).

Figure 1

(A) Perioral …

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