Fatal angioedema induced by angiotensin conversion enzyme (ACE) inhibitors

  • Marianne Tiemensma Division of Forensic Medicine, Department of Pathology, University of Stellenbosch
  • Elsie Helena Burger Division of Forensic Medicine, Department of Pathology, University of Stellenbosch
  • Jacob Johannes Dempers Division of Forensic Medicine, Department of Pathology, University of Stellenbosch
  • Shabbir Ahmed Wadee Division of Forensic Medicine, Department of Pathology, University of Stellenbosch
Keywords: Unnatural deaths, ACE-inhibitors, Angioedema, Side-effect, Hypertension.

Abstract

Angioedema is a rare, but well-described side-effect of treatment with ACE-inhibitors. We present 2 cases of fatal angioedema induced by ACE-inhibitor therapy. We suspect that this condition is under-reported, and often misdiagnosed as a natural cause of death. The importance of referral for, and performance of autopsies in suspected cases, is emphasized. The incidence of this fatal complication in the South African population needs to be ascertained, especially in view of the high incidence of hypertension and the risk of angioedema in the black population.

Author Biographies

Marianne Tiemensma, Division of Forensic Medicine, Department of Pathology, University of Stellenbosch
MBChB (Pret) Dip For Med (SA), Registrar Division of Forensic Medicine, Department of Pathology
Elsie Helena Burger, Division of Forensic Medicine, Department of Pathology, University of Stellenbosch
MB.Ch.B. (Pret), FC For Path (SA), MMed Forens Pat (Stell), Senior Specialist, Division of Forensic Medicine, Department of Pathology
Jacob Johannes Dempers, Division of Forensic Medicine, Department of Pathology, University of Stellenbosch
MB.Ch.B. (Stell), DIP FOR MED (SA), FC FOR PATH (SA), CML (Unisa), Principal Specialist, Division of Forensic Medicine, Department of Pathology
Shabbir Ahmed Wadee, Division of Forensic Medicine, Department of Pathology, University of Stellenbosch
BSc, MBChB, MMed Path (Forens), FC FOR PATH (SA), Professor and Head of Department, Division of Forensic Medicine, Department of Pathology
Published
2009-11-22
Issue
Vol 52, No 3 - May/June 2010
Section
Case studies
By submitting manuscripts to SAFP, authors of original articles are assigning copyright to the South African Academy of Family Physicians. Copyright of review articles are assigned to the Publisher, Medpharm Publications (Pty) Ltd, unless otherwise specified. Authors may use their own work after publication without written permission, provided they acknowledge the original source. Individuals and academic institutions may freely copy and distribute articles published in SAFP for educational and research purposes without obtaining permission.