Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T15:05:46.971Z Has data issue: false hasContentIssue false

Unilateral tongue angioedema caused by angiotensin-converting enzyme inhibitor

Published online by Cambridge University Press:  08 June 2010

Y S Ee
Affiliation:
Department of Otorhinolaryngology, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
A J Sow
Affiliation:
Department of Otorhinolaryngology, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
B S Goh*
Affiliation:
Department of Otorhinolaryngology, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
*
Address for correspondence: Dr Goh B S, Department of Otorhinolaryngology, UKM Medical Center, Jalan Yaakob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Fax: +603-91737840 E-mail: [email protected]

Abstract

Objective:

We report a case of an elderly man receiving treatment with perindopril, who presented with angioedema of the left side of the tongue, floor of the mouth and upper neck. This affected his speech and swallowing, and occurred one day after a burr hole and evacuation procedure undertaken to treat a subdural haematoma. The patient was kept under close observation and treated with intravenous hydrocortisone. The angioedema resolved completely in two days. This is the third reported case of unilateral tongue angioedema occurring secondary to angiotensin-converting enzyme inhibitor use.

Method:

Case report and literature review concerning angiotensin-converting enzyme inhibitor induced angioedema.

Conclusion:

Unilateral angioedema of the tongue is a rare adverse reaction to angiotensin-converting enzyme inhibitors. Early recognition may prevent unnecessary surgical intervention and complications.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Temino, VM, Peebles, RS Jr.The spectrum and treatment of angioedema. Am J Med 2008;121:282–6CrossRefGoogle ScholarPubMed
2Nazaneen, NG, Ziad, ED, Stanley, HC. Clinical experience with angiotensin-converting enzyme inhibitor-induced angioedema. Otolaryngol Head Neck Surg 2007;137:931–5Google Scholar
3Malde, B, Regalado, J, Greenberger, PA. Investigation of angioedema associated with the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Ann Allergy Asthma Immunol 2007;98:5763CrossRefGoogle ScholarPubMed
4Cugno, M. Bradykinin and the pathophysiology of angioedema. Int Immunopharmacol 2003;3:311–17CrossRefGoogle ScholarPubMed
5Mlynarek, A, Hagr, A, Kost, K. Angiotensin-converting enzyme inhibitor-induced unilateral tongue angioedema. Otolaryngol Head Neck Surg 2003;129:593–5Google ScholarPubMed
6Chan, YF, Kalira, D, Hore, P. Angiotensin-converting enzyme inhibitors as a cause of unilateral tongue angioedema in a 68-year-old woman. Am J Emerg Med 2006;24:249–50CrossRefGoogle ScholarPubMed
7Ishoo, E, Shah, UK, Grillone, GA, Stram, JR, Fuleihan, NS. Predicting airway risk in angioedema: staging system based on presentation. Otolaryngol Head Neck Surg 1999;121:263–8CrossRefGoogle ScholarPubMed
8Zirkle, M, Bhattacharyya, N. Predictors of airway intervention in angioedema of the head and neck. Otolaryngol Head Neck Surg 2000;123:240–5CrossRefGoogle ScholarPubMed
9Haymore, BR, Yoon, J, Mikita, CP, Klote, MM, DeZee, KJ. Risk of angioedema with angiotensin receptor blockers in patients with prior angioedema associated with angiotensin-converting enzyme inhibitors: a meta-analysis. Ann Allergy Asthma Immunol 2008;101:495–9CrossRefGoogle ScholarPubMed