Angioedema or Swelling of Tongue
Mouth | Anesthesia | Angioedema or Swelling of Tongue (Symptom)
Angioedema, also known by the term of Quincke's edema, is characterized by a rapid swelling of the tissues of the tongue, involving dermis, subcutaneous tissue, mucosa and submucosal tissue. It is very much alike urticaria, but urticaria, also called hives, appear in the upper dermis. The term angioneurotic edema was used for this condition because it was believed that the nervous system was involved, but this hypothesis is no longer available.
Angioedema may cause sudden difficulty in breathing, swallowing, and speaking, accompanied by swelling of the lips, face, and neck, depending on the area of the body affected. The skin of the face, normally around the mouth, and the mucosa of the mouth and/or throat, as well as the tongue, swell up over the period of minutes to several hours. The swelling can also occur elsewhere, typically in the hands. The swelling can be itchy or painful. There may also be slightly decreased sensation in the affected areas due to compression of the nerves. Urticaria or hives may develop simultaneously.
Angioedema that affects the throat and the larynx is potentially life-threatening because the swelling can block the airway, causing asphyxia.
The most common cause is a sudden allergic reaction to food. Less commonly, it results from allergy to a drug such as penicillin drug), a reaction to an insect bite or sting, or from infection, emotional stress, or exposure to animals, moulds, pollens, or cold conditions. There is also a hereditary form of the disease.
Diagnosis and Treatment
The diagnosis is made on the clinical picture. Routine blood tests - complete blood count, electrolytes, renal function, liver enzymes - are carried on . Mast cell tryptase levels may be elevated if the attack was due to an acute allergic reaction. When the patient has been stabilized, particular investigations may clarify the exact cause.
Severe cases are treated with injections of adrenaline epinephrine and may require intubation or tracheostomy, a surgical creation of a hole in the windpipe, to prevent suffocation. Corticosteroid drugs may also be given. In less severe cases, antihistamine drugs may relieve symptoms.