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Hypotensive shock and angio‐oedema from angiotensin II receptor blocker: a class effect in spite of tripled tryptase values
Author(s) -
NIELSEN E. W.
Publication year - 2005
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.2005.01547.x
Subject(s) - tryptase , irbesartan , medicine , angioedema , anaphylaxis , shock (circulatory) , angiotensin ii , degranulation , bradykinin , endocrinology , immunology , allergy , pharmacology , receptor , mast cell , blood pressure
. In adverse reactions with shock, tripled tryptase values can support a diagnosis of anaphylaxis. A 51‐year old physically fit woman experienced angio‐oedema and hypotensive shock after irbesartan ingestion requiring noradrenaline infusion. Serum tryptase rose to three times the normal value. Total immunoglobulin E and skin prick tests were normal, however. As nonallergic increases in tryptase have been observed, e.g. during angio‐oedema from angiotensin‐converting enzyme inhibitors, and bradykinin itself can degranulate mast cells acutely, we interpret the reaction as a class effect. To our knowledge, our report is one of the first on shock and angio‐oedema from irbesartan.