Valsartan
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Angioedema in an elderly patient: case report An 81-year-old man experienced angioedema of the oral floor and epiglottis following treatment with valsartan for hypertension. The man, who had an implanted pacemaker, presented with dysarthria due to oral floor and tongue swelling, which had persisted for 3 hours. He was receiving valsartan 80 mg/day [route not stated], which he had been taking for > 3 years. Examination revealed a swollen tongue pushed out by bilateral watery oedema of the mouth floor. Laryngoscopy showed significant swelling of the epiglottis, which obstructed the upper airway. CT scan results were consistent with previous findings. Tests revealed the following: CRP 3.1 mg/dL, WBC count 6800/µL, prothrombin time INR 1.30 and activated partial thromboplastin time 51.7 seconds. His prothrombin time was also prolonged. Angioedema (Quincke oedema) was diagnosed with valsartan suspected as the responsible factor. Valsartan was withdrawn, and hydrocortisone, dexamethasone and cefazolin were initiated. The man’s condition improved with regression of oedema located to the epiglottis. After 48 hours, the angioedema resolved, and he subsequently returned home. Author comment: "In our case, valsartan was administrated for 3 years." Shino M, et al. Angiotensin II receptor blocker-induced angioedema in the oral floor and epiglottis. American Journal of Otolaryngology 32: 624-626, No. 6, Dec 2011. Available from: URL: http://dx.doi.org/10.1016/j.amjoto.2010.11.014 803065382 Japan
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Reactions 14 Jan 2012 No. 1384
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