Polymyalgia rheumatica and angioneurotic edema developed during chronic treatment with an ACE inhibitor
Medical Review (Med. pregled), 2024, 60(1), 49-52.
R. Gancheva1, At. Koundurdjiev2, P. Yankova3, L. Marinchev1
1 Clinic of Rheumatology, University Hospital Sofiamed, Sofia University Sv. Kl. Ohridski
2 Clinic of Nephrology, University Hospital Sv. Iv. Rilski, Medical University – Sofia
3 Laboratory of Clinical Immunology, University Hospital Alexandrovska, Medical University – Sofia
Abstract. Polymyalgia rheumatica is a rare inflammatory rheumatic disorder. ESR and C-reactive protein are among the well-known laboratory markers for disease activity in these patients. Angioneurotic edema develops due to changes in vascular permeability and tone, frequently at the background of medications that affect vascular tone. We present a 67-years-old female patient diagnosed with Polymyalgia rheumatica. Corticosteroid treatment lead to clinical remission and normalization of acute phase parameters. At the background of remission, the patient developed angio-neurotic edema during the intake of ACE inhibitor for 1.5 years. Three months after the resolution of edema and the cessation of АСЕ-inhibitor, high levels of acute phase indicators persisted in the absence of any other underlying inflammation. After thorough review of the accessible literature, we believe that the retention of elevated levels of ESR and CRP is related to the experienced angioedema.
Key words: рolymyalgia rheumatica, ACE-inhibitors, аngioedema
Address for correspondence: Rada Gancheva, MD, PhD, е-mail: rada_ga@mail.bg