Another Crohn's Disease Mimicker: A Case of Angiotensin-Converting Enzyme Inhibitor-Induced Intestinal Angioedema

Angiotensin-converting enzyme inhibitors are a common cause of drug-induced angioedema, which rarely affects the gut. We present a 32-year-old White woman with Crohn's disease on lisinopril experiencing 1 year of episodic abdominal pain, nausea, and vomiting, prompting multiple steroid tapers and a switch in biologic therapy. She was hospitalized and was profoundly hypotensive on arrival. Initial imaging showed marked small bowel wall thickening and free fluid in the abdomen. She had rapid symptomatic and radiographic improvement after only 24 hours and was diagnosed with angiotensin-converting enzyme inhibitor-induced intestinal angioedema, an important Crohn's disease mimicker that may lead to unwanted management if unrecognized.