Angioedema following venipuncture in a patient on angiotensin-converting enzyme inhibitor and dipeptidyl peptidase-IV inhibitor therapy: A case report

Abstract

Acquired angioedema (AAE) is a rare, potentially life-threatening condition, primarily induced by medications, with attacks typically triggered by major trauma. We report a rare case of AAE triggered locally by minor trauma—a forearm venipuncture—in a 77-year-old male taking ramipril and sitagliptin. The venipuncture and these medications acted synergistically through distinct pathways in bradykinin metabolism, resulting in localized AAE. This case highlights the importance of recognizing minor trauma as a potential trigger in patients on multiple AAE-inducing medications.