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Angioedema of the airway: an unusual case

Published online by Cambridge University Press:  31 May 2007

A J Roper ,
A Farragher ,
J J Homer  and
M Helbert
A J Roper*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Immunology, Manchester Royal Infirmary, UK.
A Farragher
Affiliation:
Immunology, Manchester Royal Infirmary, UK
J J Homer
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Immunology, Manchester Royal Infirmary, UK.
M Helbert
Affiliation:
Immunology, Manchester Royal Infirmary, UK
*
Address for correspondence: Miss A J Roper, 52 Goulden Road, West Didsbury, Manchester M20 4YF, UK. E-mail: ajroper@doctors.org.uk
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Abstract

We report a case of angioedema caused by angiotensin-converting enzyme inhibitor and topical lignocaine spray, administered during nasendoscopy.

Angioedema induced by angiotensin-converting enzyme inhibitors is a rare but well known entity. Allergy to topical lignocaine has been acknowledged as a rare phenomenon when used for dental surgery and for skin anaesthesia, but it has not previously been reported after topical administration prior to nasendoscopy. In the reported case, our patient was unfortunate enough to be allergic to both lisinopril and lignocaine. The result was life-threatening airway obstruction, and the continued use of lignocaine spray sustained the laryngeal oedema. We advise that patients are asked about any and every allergy – specifically, any previous problems with dental procedures – before administration of local anaesthetic spray to the upper aerodigestive tract.

Keywords

AngioedemaAngioneurotic EdemaAngiotensin Converting Enzyme InhibitorLocal Anesthetic Allergy

Information

Type
Online Only Clinical Records
Information
The Journal of Laryngology & Otology , Volume 121 , Issue 8 , August 2007 , E11
Copyright
Copyright © JLO (1984) Limited 2007

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References

1Sondhi, D, Lippmann, M, Murali, G. Airway compromise due to angiotensin-converting enzyme inhibitor-induced angioedema. Chest 2004;126(2): 400–4CrossRefGoogle ScholarPubMed
2Prisant, LM. Angioneurotic oedema. J Clin Hypertens (Greenwich) 2001;3:262–3CrossRefGoogle Scholar
3Cohen, EG, Soliman, AM. Changing trends in angioedema. Ann Otol Rhinol Laryngol 2001;110:701–6CrossRefGoogle ScholarPubMed
4Chiu, AG, Krowiak, EJ, Deeb, ZE. Angioedema associated with angiotensin II receptor antagonists: challenging our knowledge of angioedema and its aetiology. Laryngoscope 2001;111:1729–31CrossRefGoogle Scholar
5Satkiene, D, Kavoiuniene, A, Petrauskiene, I, Sirvyte, R. Tongue angioedema associated with angiotensin-converting enzyme inhibitor (differential diagnosis, treatment). Medicina (Kaunas) 2003;39:570–3Google ScholarPubMed
6Kumar, P, Clark, M. Clinical Medicine, 5th edn., 2002. Saunders, London, 1290Google Scholar
7Morimoto, T, Gandhi, TK, Fiskio, JM, Seger, AC, So, JW, Cook, EF et al. An evaluation of risk factors for adverse drug events associated with angiotensin-converting enzyme inhibitors. Journal of Evaluation in Clinical Practice 2004;10:499–509CrossRefGoogle ScholarPubMed
8Dean, DE, Schultz, DL, Powers, RH. Asphyxia due to angiotensin converting (ACE) inhibitor mediated angioedema of the tongue during the treatment of hypertensive heart disease. J Forensic Sci 2001;46:1239–43CrossRefGoogle ScholarPubMed
9Baluga, JC, Casamayou, R, Carozzi, E, Lopez, N, Anale, R, Borges, R et al. Allergy to local anaesthetic in dentistry. Myth or reality? Allergol Immunopathol (Madr) 2002;30:14–19CrossRefGoogle ScholarPubMed
10Amsler, E, Flauhault, P, Mathelier-Fusade, P, Aractingi, S. Evaluation of re-challenge in patients with suspected lidocaine allergy. Dermatology 2004;208:109–11CrossRefGoogle ScholarPubMed
11Rood, JP. Adverse reaction to local dental anaesthetic – “allergy” is not the cause. Br Dent J 2000;189:380–4Google Scholar
12Evans, LA, Pointing, J, Willis, EJ, Michalopulos, J, Adelstein, S. Recurrent facial swelling following dental procedures. Med J Aust 2002;177(9):522CrossRefGoogle ScholarPubMed
13Mackley, CL, Marks, JG, Anderson, BE. Delayed-type hypersensitivity to lidocaine. Arch Dermatol 2003;139:343–6CrossRefGoogle ScholarPubMed
14Yanturali, S, Ergun, N, Eminoghu, O, Kalkan, S, Tuncock, Y. Life threatening tongue angioedema associated with angioconverting enzyme inhibitor. Vet Hum Toxicol 2004;46:159Google ScholarPubMed