Angioedema of the Tongue Secondary to Allergic Reaction

Abstract

Introduction: Tongue swelling is a potentially life-threatening manifestation of allergic reactions, often due to angioedema. Prompt recognition and airway preparedness are essential to prevent airway obstruction. Case Presentation: It reports the case of an 88-year-old Chinese male who developed acute tongue swelling two hours after consuming food. He had a prior history of tongue swelling following ingestion of cough syrup. On arrival at the emergency department, he was ambulatory with stable vital signs and a normal arterial blood gas. There was no associated rash, wheeze, or hypotension. Intravenous hydrocortisone, chlorpheniramine, and ranitidine were initiated, with immediate airway precautions and standby anaesthesia and otolaryngology teams. As the swelling persisted, intravenous dexamethasone was administered at two hours. At six hours, due to unresolved swelling, intramuscular adrenaline 0.5 mg was given. The patient was subsequently admitted for further monitoring. Conclusion: This case highlights the importance of early recognition of tongue swelling as a potential airway emergency, especially in elderly patients. Timely pharmacological intervention and airway preparedness are crucial to ensure favourable outcomes in allergic reactions presenting with angioedema.