Differential Diagnosis for Swelling of the Mouth and Tongue
- Single most likely diagnosis
- ACEIs (Angiotensin-Converting Enzyme Inhibitors): This class of drugs is well-known for causing angioedema, a condition characterized by the rapid swelling of the dermis, subcutaneous tissue, mucosa, and submucosal tissues. The swelling of the mouth and tongue is a classic presentation of angioedema, which can be life-threatening if not promptly treated.
- Other Likely diagnoses
- Allergic reactions to other medications: Various medications can cause allergic reactions that manifest as swelling, including but not limited to antibiotics, NSAIDs, and certain anticonvulsants. The presentation can be similar to angioedema but is not limited to ACEIs.
- Food allergies: Certain food allergies, especially to nuts, shellfish, and other common allergens, can cause rapid swelling of the mouth, tongue, and face.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Hereditary angioedema: A rare genetic disorder that causes recurrent episodes of severe swelling. It is crucial to distinguish this from drug-induced angioedema, as the treatment approaches can differ significantly.
- Anaphylaxis: A severe, life-threatening allergic reaction that can cause swelling of the mouth and tongue, among other symptoms. Prompt recognition and treatment are critical.
- Rare diagnoses
- Mastocytosis: A condition characterized by an accumulation of mast cells in one or more organs, which can lead to episodes of swelling, including angioedema-like symptoms.
- Acquired angioedema: Caused by the deficiency of C1 esterase inhibitor, which can be acquired due to lymphoproliferative diseases or autoantibodies against C1 esterase inhibitor. This condition presents similarly to hereditary angioedema but has different underlying causes.