Oedema eyelid

Phenergan contains the antihistamine promethazine. Valium contains the benzodiazepine diazepam. Both the antihistamine and the benzodiazepine tend to reduce the blink rate, leading to dry eyes. Cilest is a combined oral contraceptive, which, like other oral contraceptives, may cause reduced tolerance because of corneal and eyelid oedema. 

The majority of clinically definite and immunologically confirmed reactions have erythema as a main feature. Erythema is, however, a common accompaniment to the administration of many drugs, often as a result of directly mediated histamine release, and it should not be regarded as part of a life-threatening reaction unless there are changes in other systems of the body. In addition, most reactors have oedema, particularly of the eyelids. 

These are probably the commonest type of drug allergy. Reactions may be generalised, but frequently are worst in and around the external area of administration of the drug. The eyelids, lips and face are usually most affected. They are usually accompanied by itching. Oedema of the larynx is rare but may be fatal. They respond to adrenaline (epinephrine) (i.m. if urgent), ephedrine, Hj-receptor antihistamine and adrenal steroid. 

A patient with a recurrence of a gastrointestinal stromal tumour was given imatinib 400 mg daily without adverse effect. However, after 2 months, lansoprazole 15 mg daily was also given for dyspepsia and the patient developed bilateral eyelid oedema with hyperaemic conjunctivae and labial oedema. Both drugs were stopped, but on reintroduction the symptoms re-... 

A kidney transplant patient taking sirolimus 9 mg daily developed non-pitting oedema of the eyelid, cheek and lips when he started to take ramipril (dose not specified). Another kidney transplant patient who had taken enalapril 2.5 mg daily for two months developed erythematous skin lesions with non-pitting oedema of the neck, face and chest 9 days after she was switched from tacrolimus to sirolimus 2 mg daily. Symptoms resolved in both patients when the ACE inhibitor was stopped and corticosteroid therapy was increased. ... 

The localisation of the lesions does not fit the normal pattern for construction workers. Even though lesions on the hands (Fig. 2) can be observed in up to 75% of patients, about 50% of them present with lesions on the face (Fig. 3), principally oedema of the eyelids, which suggests airborne exposure or indirect contact. The high sensitising capacity of epoxy-resin floorings is confirmed by the early onset of sensitisation (usually within 6 months of exposure) in most cases. 

An allergic hypersensitivity reaction -generalized itching, erythema and oedema of the eyelids — occurred with Dextran 70 during hysteroscopy for removal of an implanted Daikon shield. No previous exposure to dextran was known to the patient. Dextran was given to prevent anticipated bleeding (34 ). 

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