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Nickel and Sulfites Food Allergy in Patients With Angioedema Associated With ACE Inhibitor Use—Reply
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In reply
De Marchi et al found a very high frequency of sensitizations to food and additives in patients using ACE inhibitors experiencing angioedema, urticaria, or itching. Complete disappearance of symptoms on withdrawal of the ACE inhibitor in 86% of patients and a temporal cause-effect relationship between food/additive exposure and appearance of symptoms support the view that food and additive sensitizations could be "the" or "one of the" condition(s) leading to ACE inhibitor–related dermatologic symptoms. The authors also suggest that exposure to foods containing the substances to which patients were sensitized could agonistically act with the ACE inhibitor in increasing availability of bradykinin to cause the symptom. These correlates do not apply to the 61 patients with ACE inhibitor–related angioedema that we previously reported.1 They were indeed considered for the study only when the clinical history excluded a relationship of angioedema to potential causative agents as food, drugs, and chemicals. . . . [Full Text of this Article]
AUTHOR INFORMATION
Marco Cicardi, MD;
Lorenza C. Zingale, MD
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