Angioedema Lip

Recently, a patient presented with angioedema after starting taking an ACE-inhibitor. There was upper lip swelling, similar appearing to the case above. He also experience a hoarse voice. Before the advent of fiberoptic nasopharyngoscopy, it was assumed that there may be laryngeal edema. Fortunately, using technology, we were able to visualize a normal epiglottis and a grossly normal laryngeal anatomy.

Should patient with angioedema be admitted?

The 1999 study on admission guidelines, of course, should be weighed with physician judgment and the patient’s social issues. The study was retrospective and the results should be weighed carefully. For me, generally I admit all intraoral angioedema cases and progressively worsening extraoral angioedema. I also perform fiberoptic nasopharyngoscopy on all patients with voice changes.

PV Card: Angioedema


Adapted from 1
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1.
Temiño V, Peebles R. The spectrum and treatment of angioedema. Am J Med. 2008;121(4):282-286. [PubMed]
Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD

@M_Lin

Professor of Emerg Med at UCSF-Zuckerberg San Francisco General. Founder of ALiEM @aliemteam #PostitPearls https://t.co/7v7cgJqNEn
Michelle Lin, MD