Russo Thomas, Kouyoumjian Sarkis, Fargaly Hithem
Emergency Medicine, Wayne State University School of Medicine, Detroit, USA.
Emergency Medicine, Wayne State University Detroit Medical Center, Detroit, USA.
Cureus. 2023 Jul 20;15(7):e42202. doi: 10.7759/cureus.42202. eCollection 2023 Jul.
Angioedema is a documented but uncommon adverse effect of dihydropyridine calcium channel blockers such as amlodipine. We present the case of a 38-year-old man who presented to the emergency department (ED) with severe swelling of his upper lip that had begun earlier in the day. His medical history was notable for hypertension treated with amlodipine; his only other medication was a multivitamin. The patient denied any known drug allergies, new foods, insect bites, recent travel, or sick contacts. Physical examination showed hypertension and massive edema isolated to the upper lip; it was otherwise unremarkable. Laboratory results showed no abnormalities aside from a slight normocytic anemia. The patient was diagnosed with angioedema, with amlodipine suspected as the cause. Amlodipine was discontinued and treatment was initiated with IV glucocorticoids and diphenhydramine. The swelling improved steadily over the next 36 hours and the patient was discharged on hospital day 3.
血管性水肿是一种已被记录但并不常见的二氢吡啶类钙通道阻滞剂(如氨氯地平)的不良反应。我们报告一例38岁男性病例,该患者因当日早些时候开始出现的上唇严重肿胀而就诊于急诊科。他有高血压病史,正在服用氨氯地平治疗;他仅服用的其他药物是一种多种维生素。患者否认有任何已知的药物过敏、新食用的食物、昆虫叮咬、近期旅行或患病接触史。体格检查显示高血压以及仅局限于上唇的严重水肿;其他方面均无异常。实验室检查结果除轻度正细胞性贫血外无其他异常。患者被诊断为血管性水肿,怀疑病因是氨氯地平。停用氨氯地平,并开始使用静脉糖皮质激素和苯海拉明进行治疗。在接下来的36小时内肿胀逐渐改善,患者于住院第3天出院。