Clinical Case Discussion

General
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  1. A 52-year-old woman comes to the clinic with swelling and itching on her lips for the last 2 days. The swelling started suddenly. It is not painful, but it is uncomfortable. She has no fever, no breathing problems, and no rash on the rest of her body.

She has high blood pressure and has been taking Amlodipine (5 mg daily) for the past 6 months. She has not started any new medicine and has no known allergies.

On Examination,
-Vitals are stable
-There is swelling on her lips, but no signs of infection or injury.
-Her chest is clear, and she is breathing normally.

What is the possible diagnosis?
What is the next line of management?

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it can be angioedema or allergic reaction

we can use antihistamines and corticosteroids may be used to reduce swelling and itching

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Might be allergy, angioedema is usually seen with Ace-I not amlodipine (CCB). Try an antihistamine, if it works well and good

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I guess it is amlodipine induced angioedema.

Next line for management
Stop Amlodipine temporarily.
Administer antihistamines (e.g., cetirizine) and corticosteroids if swelling is significant.
Monitor airway closely for any progression.
If swelling worsens or breathing difficulty develops, emergency treatment with epinephrine may be needed.

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True! EpiPen should be kept ready.

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As stated above, it is angioedema. The treatment described above is in right direction.
However, Epipen must be kept ready.

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