Functional airway obstruction mimicking tongue angioedema

Citation
Me. Nordness et Mc. Zacharisen, Functional airway obstruction mimicking tongue angioedema, ANN ALLER A, 83(6), 1999, pp. 540-542
Citations number
14
Categorie Soggetti
Clinical Immunolgy & Infectious Disease
Journal title
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY
ISSN journal
10811206 → ACNP
Volume
83
Issue
6
Year of publication
1999
Part
1
Pages
540 - 542
Database
ISI
SICI code
1081-1206(199912)83:6<540:FAOMTA>2.0.ZU;2-N
Abstract
Background: Functional causes of upper airway obstruction have focused prim arily on psychogenic strider associated with paradoxical vocal cord dysfunc tion. Angioedema can involve upper airway structures and be life-threatenin g. Case Report: We report a 12-year-old female with upper airway obstruction f rom posterior tongue swelling which was determined to be a conversion react ion. Methods & Results: A lateral neck film revealed severe tongue swelling. Exa mination revealed a calm, cooperative patient in no distress but exhibiting inspiratory and expiratory strider. A computed tomography scan revealed so ft tissue fullness at the base of the tongue without associated lymphadenop athy. Laboratory evaluation was normal. With anesthetic induction in the op erating room, there was complete relaxation of the upper airway with no evi dence of tongue swelling, mass, or other abnormality. Following tongue biop sy, she had no reoccurrence of the tongue mass. Conclusion: This case represents a childhood conversion reaction of functio nal airway obstruction where tongue manipulation simulated tongue swelling radiographically consistent with angioedema.