Angioedema Caused by Carbamazepine or Acetazolamide: A Single Drug Solution – An illustrative Case Report
Urticaria manifests as a skin eruption consisting of raised, intensely itchy papules or
wheals which involves superficial dermis. In contrast, angioedema is a result deeper
subcutaneous and submucosal tissue edema.
Both are caused by post capillary venule inflammation
resulting in fluid leakage. Clinical manifestations and etiology of acute onset angioedema are
variable. Carbamazepine and acetazolamide like many other drugs may produce mild to severe
adverse reactions.1,2 Indeed angioedema is a rare complication of drug therapy in children.
The incidence peaks the third decade of life. Women are more often affected than men. Culprit drugs
include analgesics, antibiotics, and contrast media. In the adult literature angiotensin-converting
enzyme inhibitors are probably the best documented drugs that can induce angioedema.
However, there is a lack of published report of carbamazepine or acetazolamide-induced angioedema
in children.
By illustrating an acute onset angioedema, we discuss a single drug solution particularly in those patients in whom the memory of side effects of the drug is a vivid reality.
A 15 year-old female presented with an acute onset skin rashes, as well as painless lip,
and eyelid swelling. She had no breathing difficulties.
Her past history included supraventricular tachycardia, generalized epilepsy, an idiopathic increased intracranial pressure and disabling migraine attacks. The presenting symptoms occurred on the 26th day of starting carbamazepine (3.6 mg/kg/day) and acetazolamide. She has been receiving daily digoxin. She had no history of
fever, systemic symptoms, and hereditary angioedema.
Neuro Open J. 2014; 1(1): 20-22. doi: 10.17140/NOJ-1-105
