Angioneurotic Edema of the Larynx Due to Sensitivity to Chicle: Report of a Case

Abstract

Angioneurotic edema has been described by Jackson 1 as a disease characterized by transient circumscribed edematous swellings on mucosal or epidermal surfaces or on both. The larynx alone may be involved, but more commonly there are associated lesions in the gastrointestinal tract, esophagus, mouth, tongue, pharynx, lips, eyelids, skin or genitalia.There are many causes of edema of the larynx, for example, acute infections of the pharynx and the larynx; disorders following ingestion of hot liquids or foods; inhalation of powerful chemicals; nephritic and cardiac conditions; prolonged use of iodides ; foreign bodies in the piriform sinuses, bronchi or upper part of the esophagus; tuberculosis, syphilis, leprosy and neoplasms of the larynx, and wounds of the larynx. The distinction between the angioneurotic type of laryngeal edema and the conditions just named presents little difficulty. The typical picture of angioneurotic laryngeal edema is that of a patient suddenly seized with a tickling cough, a lumpy feeling in the throat, difficulty in swallowing and dyspnea of varying degrees, with or without hoarseness, together with angioneurotic manifestations in other regions, such as the skin, nose and eyes and possibly the gastrointestinal tract. A family history of similar or other manifestations of allergy is frequently present. Osier 2 reported the occurrence of angioneurotic edema throughout five generations in one family. Even in the absence of such a history or of associated findings such as those mentioned, acute edema of sudden onset accompanied by the symptoms described is usually of the angioneurotic type. The edema, as observed in mirror laryngoscopic examination, differs from the inflammatory and nephritic edema, which convey an impression of watery softness like that of an edematous polyp. Angioneurotic edema does not look as if a puncture would liberate water; it appears firmer.