Symptoms of ACE inhibitor-induced angioedema

Q: Which of the following symptoms is notably absent in Angiotensin-converting enzyme (ACE) inhibitors-induced angioedema? (select one)

A) swelling of the lips, tongue, or face

B) episodic abdominal pain 

C) urticaria and itching 

Answer: C

Although swelling of the lips, tongue, or face is very well known with ACE-inhibitors-induced angioedema, episodic abdominal pain is less well known. Like edema of lips, tongue, or face, intestinal angioedema may also occur leading to episodic abdominal pain.

Urticaria and itching are very unusual.

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References:

1. Kostis WJ, Shetty M, Chowdhury YS, Kostis JB. ACE Inhibitor-Induced Angioedema: a Review. Curr Hypertens Rep. 2018 Jun 8;20(7):55. doi: 10.1007/s11906-018-0859-x. PMID: 29884969.

2. Brown T, Gonzalez J, Monteleone C. Angiotensin-converting enzyme inhibitor-induced angioedema: A review of the literature. J Clin Hypertens (Greenwich). 2017 Dec;19(12):1377-1382. doi: 10.1111/jch.13097. Epub 2017 Oct 10. PMID: 28994183; PMCID: PMC8031276.