Document Detail

Isolated non-hereditary angioneurotic oedema of uvula (Quincke's disease) in an adolescent.
MedLine Citation:
PMID:  24717596     Owner:  NLM     Status:  In-Data-Review    
A 19-year-old primipara woman was admitted in labour with positive vaginal swab for group B Streptococcus and given benzylpenicillin and ranitidine. She used Entonox for pain relief. She received bupivacaine in the epidural catheter and shortly after developed sensation of foreign body in her throat with muffled voice and isolated angioneurotic oedema of the uvula. She responded well to H1 and H2 histamine blockers and steroids and epinephrine were kept as standby. She recovered well soon after delivery. Penicillin, Entonox or bupivacaine seemed possible cause of the Quincke's disease. Hereditary form was ruled out by normal creatine kinase and reaction to bupivacaine by C1 esterase inhibitor assay. It can be associated with spectrum of anaphylactic reactions and the resuscitation team should be alerted. Airway maintenance should be the primary management strategy. Most cases respond to observation, oxygen therapy and antihistamines with or without steroids. Epinephrine may be required occasionally.
Ramnik V Patel; Cho Cho; Christopher Medd; Janet Cresswell
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Publication Detail:
Type:  Journal Article     Date:  2014-04-09
Journal Detail:
Title:  BMJ case reports     Volume:  2014     ISSN:  1757-790X     ISO Abbreviation:  BMJ Case Rep     Publication Date:  2014  
Date Detail:
Created Date:  2014-04-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101526291     Medline TA:  BMJ Case Rep     Country:  England    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  IM    
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