Differential Diagnosis for Lip and Facial Swelling
- Single most likely diagnosis
- Angioedema due to ACE inhibitor (lisinopril): The patient has been taking lisinopril for a year and presented with facial swelling the next day after taking the medication, which is a known side effect of ACE inhibitors. The absence of other symptoms such as hives, pruritis, or respiratory distress also points towards angioedema.
- Other Likely diagnoses
- Allergic reaction: Although the patient does not have any other symptoms of an allergic reaction, it is still possible that the facial swelling is due to an allergic reaction to another substance, such as a food or environmental allergen.
- Nephrotic syndrome: The patient has a history of CKD, and nephrotic syndrome can cause facial swelling due to hypoalbuminemia.
- Heart failure: The patient has a history of hypertension and is overweight, which increases the risk of heart failure. Heart failure can cause facial swelling due to fluid overload.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Anaphylaxis: Although the patient does not have any respiratory symptoms, anaphylaxis can present with isolated facial swelling and can be life-threatening if not treated promptly.
- Superior vena cava syndrome: This is a rare but life-threatening condition that can cause facial swelling due to obstruction of the superior vena cava.
- Tracheal obstruction: The patient has a history of OSA and is intolerant to CPAP, which increases the risk of tracheal obstruction. Tracheal obstruction can cause facial swelling due to increased pressure in the face and neck.
- Rare diagnoses
- Hereditary angioedema: This is a rare genetic disorder that can cause recurrent episodes of angioedema, often without any other symptoms.
- Acquired angioedema: This is a rare condition that can cause angioedema due to underlying conditions such as lymphoma or autoimmune disorders.
- Sjögren's syndrome: This is a rare autoimmune disorder that can cause facial swelling due to inflammation of the salivary and lacrimal glands.