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AJNR - American Journal of Neuroradiology

Published ahead of print on September 3, 2008
doi: 10.3174/ajnr.A1263

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American Journal of Neuroradiology 30:77-78, January 2009
© 2009 American Society of Neuroradiology

Case Report
HEAD & NECK

Unusual Radiographic Appearance of Drug-Induced Pharyngeal Angioedema and Differential Considerations

S.P. Raman^a, B.E. Lehnert^a and S. Pruthi^b

^a University of Washington, Seattle, Wash
^b University of Washington's Children's Hospital and Regional Medical Center, Seattle, Wash

Please address correspondence to Sumit Pruthi, MD, R-5417–Radiology, Children's Hospital and Regional Medical Center (University of Washington), 4800 Sand Point Way NE, Seattle, WA 98105; e-mail: sumitp{at}u.washington.edu

SUMMARY: A 59-year-old woman treated chronically with enalapril, an angiotensin-converting enzyme inhibitor (ACE-I) presented with difficult swallowing and speaking. Although her symptoms were clinically consistent with an adverse angioedema reaction to the ACE-I, initial imaging was not entirely consistent with our conceptual understanding of angioedema. This case report will discuss the myriad possible imaging presentations of this disease, as well as the differential diagnosis for this atypical manifestation of ACE-I–induced angioedema.