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Lack of efficacy: case report A 48-year-old man exhibited lack of efficacy with epinephrine, unspecified antihistamines and unspecified glucocorticoids for orolingual angioedema. The man, who had been receiving lisinopril for hypertension, presented with ischaemic cerebral vascular accident and received unspecified tissue plasminogen activator. He developed severe bilateral tongue angioedema within few minutes of the treatment, requiring intubation and tracheostomy. He then received epinephrine along with unspecified antihistamines and unspecified glucocorticoids [dosages and routes not stated]. However, no improvement was observed. Further, he received botulinum toxin and bite blocks were placed, which provided mild relief. A gradual improvement was noted with daily graduated compression wrappings of the tongue to promote resorption. Six weeks later, his tongue returned to baseline. Author comment: "He was treated with epinephrine, antihistamines and glucocorticoids with no improvement." Neupert K, et al. REFRACTORY TONGUE ANGIOEDEMA INDUCED BY TISSUE PLASMINOGEN ACTIVATOR. Annals of Allergy, Asthma and Immunology 123 (Suppl.): S97-S98, No. 5, Nov 2019. Available from: URL: 803431931 https://www.annallergy.org/issues [abstract] - USA

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Reactions 9 Nov 2019 No. 1778