Angiotensin-Converting Enzyme Inhibitor (ACEI)-Induced Angioedema After Re-exposure to Lisinopril: A Case Report and Clinical Review

Angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema is an uncommon but potentially life-threatening adverse effect that can occur unpredictably, even after prolonged use. Prompt recognition and appropriate management are essential. We present the case of a 54-year-old Caucasian male with a history of ACEI-induced angioedema who developed isolated lingual swelling after re-exposure to lisinopril. His symptoms were unresponsive to antihistamines, corticosteroids, and epinephrine but resolved with supportive care following ACEI discontinuation. This case underscores the risk of recurrent angioedema following ACEI re-exposure and reinforces the recommendation for lifelong avoidance of ACEIs in patients with a prior diagnosis of ACEI-induced angioedema. Angiotensin receptor blockers (ARBs), which carry a lower risk of angioedema, may serve as preferred alternatives in high-risk patients. Patient education remains critical to preventing recurrence.