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Unilateral Tongue Angioedema Induced by Angiotensin Converting Enzyme Inhibitor: A Case Report
Zamzam Khalaf Al-Hoqani1, Maisa Hamed Al-Kiyumi2, Salem Hamdan Al-Tamemi3
1Directorate General of Primary Health Care, Ministry of Health, Dakhilyia Region, Oman.
Oman Medical Journal
|February 12, 2020
Summary
Angiotensin-converting enzyme inhibitor-induced tongue angioedema is common, but unilateral cases are rare. This report details a unique instance of unilateral tongue swelling in a patient using lisinopril for two years.
Area of Science:
- Cardiology
- Pharmacology
- Emergency Medicine
Background:
- Angiotensin-converting enzyme inhibitors (ACEIs) are frequently prescribed for hypertension and heart failure.
- Tongue angioedema is a known, albeit uncommon, adverse effect of ACEIs, typically occurring early in treatment.
- Unilateral tongue angioedema is an exceptionally rare presentation of this side effect.
Observation:
- A 78-year-old female presented with acute onset of unilateral right-sided tongue angioedema.
- The patient had been taking lisinopril, an ACEI, for two years prior to symptom onset.
- No respiratory distress or airway compromise was observed.
Findings:
- The angioedema resolved spontaneously within 12 hours without specific intervention.
- Discontinuation of lisinopril was implemented as a precautionary measure.
- No recurrence of angioedema was reported following lisinopril cessation.
Implications:
- This case highlights that ACEI-induced angioedema, including unilateral tongue involvement, can manifest even after prolonged use.
- Clinicians should maintain a high index of suspicion for angioedema in patients on ACEIs, regardless of treatment duration.
- Delayed onset and unusual presentations underscore the importance of thorough medication history and patient monitoring.
