Back Story

Early this year I took one week of antibiotics to deal with possible developing cellulitis. About a year prior, I took the antibiotic for a prior incidence of cellulitis. I have been taking just one regular prescription drug (L) for the last few years.

About two weeks after finishing the antibiotics, I developed itching in the legs which I expected to just fade away. Suddenly I had eye edema as shown, rashes, etc. A lot of other symptoms that my wife (with verified by tests) Mast Cell Activation Syndrome.

At peak	Calming down

Our medical professional prescribed high dosage of multiple anti-histamines. After two weeks there was little progress. After a lot of prompting of an AI, it suggested “L” may be a contributor. I always took this at bed time, and symptoms became much worse at night. I stopped taking it, the result was significant improvement every day since. My wife has told me that I am looking more normal every day, but I still have some distance to go.

A hint of one possible cause?

Although many many symptoms matched my wife’s MCAS symptom, it appears that histamines were not the issue.

“L”  breaks down bradykinin, so lisinopril can increase bradykinin levels; this helps vasodilation but is also linked to cough and angioedema risk.

“Bradykinin and mast cell activation can overlap because mast cells may help trigger the kallikrein-kinin system, which can increase bradykinin production. Bradykinin can also increase vascular leak and swelling, so some symptoms can look similar to MCAS flares.” Mast cell degranulation and bradykinin-induced angioedema – searching for the missing link, 2024

 Bradykinin can be measured but not usually as a routine clinical test. In practice, doctors usually test for the cause of bradykinin-related swelling rather than measuring bradykinin itself, because bradykinin is very unstable and hard to measure directly in blood. The most direct method is a specialized blood test using LC-MS/MS or a similar lab technique that measures bradykinin and its breakdown products. Some research methods use special sample handling, like drawing blood into chilled tubes and processing it very quickly, because bradykinin can change fast after the blood is drawn, Bradykinin measurement by liquid chromatography tandem mass spectrometry in subjects with hereditary angioedema enhanced by cold activation ,2025

Excessive bradykinin can be treated. In my case, the treatment was easy, stopping L.

Also note: that all of the papers being cited are 2024 and later.

Microbiome Role?

Just before these events I did a microbiome test. In two more weeks I am planning to do a second test. I will attempt to identify possible changes and how such changes could have cause these change.

Stay tune!