A case of tongue edema associated with radiation-induced ulcer with low level of C1 inhibitor activity *
A 66-year-old man became aware of sudden swelling of the tongue with swallowing disturbance. He had a medical history of tongue cancer treated by interstitial radiotherapy and had undergone a cytological examination of an ulcer on the right side of the tongue three weeks earlier because of suspected recurrence. The cytological examination result was classI with no malignant findings. Angioneurotic edema, so-called "Quincke's edema" , associated with radiation-induced ulcer of the tongue, was diagnosed. Tranexamic acid, d-chlorpheniramine maleate, and epinephrine were administered. After six days, the tongue edema had almost disappeared. Laboratory examination revealed a low level of Cl inhibitor activity with normal levels of CH50, Cl, C3, and C4 at the time of swelling. Hereditary angioneurotic edema with absence of hereditary trait was suspected based on the sudden edema attack and low level of Cl inhibitor activity. The Cl inhibitor activity returned to normal after disappearance of the tongue edema. (Accepted on November 13, 2002)
