Fulminant and fatal angioedema caused by bleomycin treatment

We encountered a case of fulminant and fatal angioedema involving skin and lungs. This reaction, hitherto unreported, occurred 48 hours after termination of a course of bleomycin sulfate. It was not predictable by skin testing, nor was it reversible with steroid therapy. The only predictive clue was the development of eosinophilia during the course of therapy. Fulminant angioedema should be added to the list of potential reactions to bleomycin.