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Emergency medicine
Unilateral tongue swelling: an unusual presentation of angiotensin-converting enzyme inhibitor-related angioedema
  1. Julian Robert Paul Eloff and
  2. Almero Oosthuizen
  1. Emergency Medicine, Karl Bremer Hospital, Cape Town, Western Cape, South Africa
  1. Correspondence to Dr Julian Robert Paul Eloff; julianeloff1302{at}gmail.com

Abstract

Angioedema is a rare but potentially fatal complication of angiotensin-converting enzyme inhibitor (ACEi) treatment. This class of drugs is widely used in the treatment of hypertension, cardiac failure and other common conditions.

This case report discusses a male patient in his 60s who presented with acute swelling of the right side of his tongue, an unusual manifestation of angioedema, which typically involves bilateral swelling of orofacial structures.

Accurate and early identification of this complication affords the opportunity for early, potentially life-saving intervention during the acute episode and also cessation of the treatment, reducing the risk of recurrence in the future.

This case is one of only a few reported in English language medical literature and the first from Africa, suggesting either rarity or under-reporting. The case contributes to the understanding of ACEi-induced angioedema, particularly in Africa where hypertension is prevalent and ACEi is commonly used.

  • Emergency medicine
  • Unwanted effects / adverse reactions

https://doi.org/10.1136/bcr-2023-257959

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    Footnotes

    • Contributors We, the authors of this research article, declare our individual contributions to the conception, execution and completion of the study entitled 'Unilateral tongue swelling: a rare presentation of angiotensin-converting enzyme inhibitor-related angioedema.' JRPE, the corresponding author, played a pivotal role in all aspects of this study. JRPE’s involvement encompassed multiple stages, starting from the initial conception of the study, caring for the patient under investigation to drafting of the text, sourcing and editing of clinical images and composing the manuscript. AO, another author of this article, contributed significantly to the manuscript preparation. AO expertise in crafting and organising the content greatly improved the clarity and coherence of the final manuscript. While their primary contribution focused on the preparatory phases of the article, their input enhanced the overall quality of the work. JRPE is responsible for the overall content as guarantor. The guarantor accepts full responsibility for the finished work and/or the conduct of the study, has access to the data and controlled the decision to publish. We affirm that all authors have reviewed and approved the final version of the manuscript and agree to its submission for publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.