A Rare Case of ACEi-associated Angioedema of the Small Bowel

Author(s): B Michael Ladna, Vanessa Rodriguez, Naueen Chaudhry, Angela Pham

A middle-aged female presented with abdominal pain, vomiting, and watery non-bloody diarrhea shortly after her lisinopril dose was increased. Extensive workup did not reveal a definite pathology however CT of the abdomen showed bowel wall thickening of the proximal jejunum. Her lisinopril was held at the start of the admission due to an acute kidney injury and hypotension. A colonoscopy was done and biopsies revealed increased intraepithelial lymphocytes at every site which is characteristic of medication induced enteropathy. She was instructed to not restart lisinopril and symptoms completely resolved. She was diagnosed with ACEi-angioedema of small bowel.

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