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Recurrent angioedema associated with pharmacological inhibition of dipeptidyl peptidase IV
  1. Thorbjørn Hermanrud1,
  2. Anette Bygum2,
  3. Eva Rye Rasmussen1
  1. 1Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
  2. 2Dermatology and Allergy Center, University Hospital of Odense, Odense, Denmark
  1. Correspondence to Dr Anette Bygum, anette.bygum{at}


Angioedema (AE) of the upper airways is a severe and potentially life-threatening condition. The incidence has been increasing in the past two decades, primarily due to increased use of medications inhibiting the degradation of vasoactive peptides. Acquired angioedema related to angiotensin-converting enzyme inhibitors (ACEI-AAE) is well known, but other pharmaceutical agents also affect the degradation of bradykinin and substance P. We present a middle-aged man with recurrent episodes of severe AE of the oral cavity, hypopharynx and larynx due to pharmacological inhibition of dipeptidyl peptidase IV.

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  • Contributors TH has been responsible for and performed the writing and preparation of figures. AB has been expert cowriter. ERR had the idea to this manuscript and has been expert cowriter.

  • Competing interests ERR has received payment for lectures from MSD Norway and Shire. She has received research grants for HAE research from Shire and genetic studies regarding angioedema from CSL Behring and ViroPharma. AB has been involved in clinical research or educational events involving CSL Behring, Jerini, AG/Shire, Sobi, and ViroPharma. TH has participated in a conference on HAE organised and paid by Shire.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.