Tongue swelling

In three other patients (two women, one man) a serum sickness-like reaction developed 6-21 days after the start of amfebutamone treatment (14). The symptoms, arthralgia, pruritus, and tongue swelling, abated within 2 weeks of treatment with oral corticosteroids. Serum sickness reactions to drugs are rare, and it will be important to find out whether amfebutamone carries an increased risk of this unusual reaction. 

Recurrent episodes of tongue swelling have been reported with cilazapril (84) and perindopril (85). 

Figure 56. Severe PPD intoxication in a female showing tongue swelling, neck swelling and tracheostomy.

Patients may develop severe cutaneous hyper-sensivity or systemic allergic reactions. Signs may include the development of an urticarial hive-type reaction, facial or tongue swelling, bronchospasm, and acute upper airway obstruction. Treatment includes antihistamines, corticosteroids, and, if necessary, epinephrine. 

Oral mucosa 30%-50% May try antifibrinolytic or topical thrombin prior to factor replacement for minor bleeding higher factor levels may be needed for tongue swelling or risk of airway compromise antifibrinolytic therapy should be used following factor replacement do not use with APCCs or PCCs... 

The Australian Adverse Drug Reactions Advisory Committee received 11 reports of adverse reactions associated with echinacea use between July 1996 and September 1997. There were three reports of hepatitis three reports of asthma one rash one of rash, myalgia, and nausea one urticaria one anaphylaxis (the previously described case) and one of dizziness and tongue swelling. Echinacea was the only reported ingestant in five of the eight reports, resembling hypersensitivity. Onset of symptoms occurred within 24 h in two cases. There are two additional published case reports of echinacea-associated contact dermatitis and anaphylaxis (Mullins, 1998). 

A single case report describes tongue swelling and respiratory obstruction in a patient given prochlorperazine and then metoclopramide. 

A family cat turned up with a suppurating jaw the Hill s Army veterinarian recognized the bone necrosis as a sign of radiation poisoning from Tech Area contamination and kept the animal alive to observe its unusual symptomatology, about which not much was yet known. Its tongue swelled and its hair fell out in patches its heartsick owner eventually asked that the animal be destroyed. 

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