Angioedema of the Intestine

To the Editor: In their image entitled “Angioedema of the Intestine” (June 20 issue), 1 Gregory and Davis did not mention the duration of lisinopril treatment. Since the diagnosis of recurrent swelling of the tongue and pharynx associated with the administration of an angiotensin-converting–enzyme (ACE) inhibitor was missed (lisinopril was continued and angioedema of the intestine developed), I assume that the patient had been treated with lisinopril for a relatively long period. Although the early onset of the ACE-inhibitor–induced angioedema should not be a diagnostic problem, many physicians are not familiar with late-onset angioedema, and it frequently goes unrecognized. 2 – 4 The . . .