A 64-Year-Old Man With Throat Swelling

Patricia Ayuk Noumedem, PharmD; Marissa Tabile; Ermias Shikur; Bini Mathews; Anthony L. Huynh; Tracy Kwaku

Disclosures

August 08, 2018

Physical Examination and Workup

Physical examination reveals a middle-aged man with swollen lips, tongue, and throat. The pharynx is edematous. The respiratory and cardiovascular system examinations reveal features of hypertensive heart disease in biventricular failure. Upon further evaluation, the patient has airway compromise and tongue swelling, requiring a tracheostomy.

C1- inhibitor (C1-INH) and complement assay levels and function are normal. Other laboratory findings include:

  • Creatinine level : 1 mg/dL (upon admission)

  • Ammonia : 59 mcg/dL

  • Alanine aminotransferase (ALT) level : 80 U/L

  • Aspartate aminotransferase (AST) level : 73 U/L

  • Lactic acid level : 4.9 mmol/L

  • White blood cell count : 15.5 × 109/L

  • Hemoglobin level : 14 g/dL

  • Hematocrit level : 42.5%

  • Platelet count : 131 × 10/mm3

  • Sodium level : 134 mEq/L

  • Potassium level : 5.6 mEq/L

  • Chloride level : 104 mEq/L

  • CO2 level : 20 mEq/L)

  • Blood urea nitrogen level : 21 mg/dL

  • Creatinine level : 2.82 mg/dL

  • Glucose level : 144 mg/dL

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....