The pt had had a previous episode of tongue swelling requiring intubation six months pta. He his lymphoma had been recognized by an allergist in the community and he was started on chemo. He was treated with danazol which has been reported to be effective in acquired angioedema. When his C1 esterase level returned to normal; he was taken off danazol. On the night pta his tongue swelled again after he bit it. It became more swollen over the next 12 hours and he came to the ED.
The pt was scoped, awake, nasally and there was oropharyngeal edema and airway narrowing centered around the R tongue. He was intubated at that time over the scope. He was given Berinert but there was no significant improvement in his swelling and he remained in the ICU for two days. He was extubated and restarted on danazole. He was discharged from the hospital.
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