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The chance of drug-induced angioedema is extremely uncommon, however, as studies show incidence of less than 1%. [4] The reason this adverse effect may occur is due to the build-up of bradykinin, a vasodilator. This causes blood vessels to dilate and allow for fluid buildup in the mucosal surfaces.
Lisinopril works by inhibiting the renin–angiotensin–aldosterone system. [7] Lisinopril was patented in 1978 and approved for medical use in the United States in 1987. [7] [11] It is available as a generic medication. [7] In 2022, it was the third most commonly prescribed medication in the United States, with more than 82 million prescriptions.
Angioedema is an area of swelling of the lower layer of skin and tissue just under the skin or mucous membranes. [1] [3] The swelling may occur in the face, tongue, larynx, abdomen, or arms and legs. [1] Often it is associated with hives, which are swelling within the upper skin. [1] [3] Onset is typically over minutes to hours. [1]
Patients present with an acute onset of swelling, pain, erythema, prominent tenderness, warmness and limited range of motion in both ankles. [1] [2] Lower legs and heels may also be involved, however the distal parts of feet and toes are usually spared. Patients may also experience high-graded fever, pitting edema and hypotension.
Peripheral edema is edema (accumulation of fluid causing swelling) in tissues perfused by the peripheral vascular system, usually in the lower limbs. In the most dependent parts of the body (those hanging distally ), it may be called dependent edema.
Causes of edema that are generalized to the whole body can cause edema in multiple organs and peripherally. For example, severe heart failure can cause pulmonary edema, pleural effusions, ascites and peripheral edema. Such severe systemic edema is called anasarca. In rare cases, a parvovirus B19 infection may cause generalized edemas. [9]
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