Differential Diagnosis for Progressive Lip Swelling
Single Most Likely Diagnosis
- ACE-Inhibitor Induced Angioedema: Given the patient's history of a similar complaint and a previous diagnosis of ACE-inhibitor induced angioedema, this is the most likely diagnosis. The patient's symptoms of progressive lip swelling without urticaria, rash, or itching are consistent with this condition.
Other Likely Diagnoses
- Idiopathic Angioedema: The patient's history of a similar reaction to ibuprofen and a family history of angioedema with ibuprofen use suggest a possible underlying predisposition to angioedema, making idiopathic angioedema a likely consideration.
- Allergic Angioedema: Although the patient denies other significant allergies, the reaction to ibuprofen as a child and the family history of similar reactions suggest the possibility of an allergic component.
Do Not Miss Diagnoses
- Hereditary Angioedema (HAE): Although rare, HAE is a life-threatening condition that can cause recurrent episodes of angioedema. The patient's family history of angioedema with ibuprofen use and his own history of similar reactions warrant consideration of this diagnosis.
- Anaphylaxis: Although the patient denies difficulty breathing or swallowing, and there is no mention of urticaria or rash, anaphylaxis is a potentially life-threatening condition that must be considered in any patient presenting with angioedema.
Rare Diagnoses
- Acquired Angioedema: This condition is associated with lymphoproliferative disorders, autoimmune diseases, or the use of certain medications. Although less likely, it should be considered if other diagnoses are ruled out.
- Angioedema due to Other Medications: The patient may be taking other medications that could cause angioedema, such as NSAIDs, estrogens, or certain antibiotics, which should be investigated as potential causes.