Enlarged uvula (Quincke’s Oedema) – A side effect of inhaled cocaine? – A case study and review of the literature

Mephedrone-induced uvulitis

“…The temperature of the inhaled smoke was suggested as a contributing factor in these cases. Our case is more similar to that reported in a patient who had inhaled powdered cocaine [3], and possibly relates to a type-1 hypersensitivity reaction [4] in addition to the tachycardia, hypertension, palpitations and respiratory difficulties more commonly described as side-effects of mephedrone [5,6], hence the rapid effectiveness of the anti-allergy medications administered. …”

Swelling and Elongated Uvula with Unilateral Vocal Cord Paralysis after General Anesthesia

“…Swelling and elongated uvula is a rare complication of general anesthesia, on the other hand, it was also reported after regional anesthesia (2,3). The reasons of uvular edema such as hereditary angioneurotic edema, irritant inhalation and allergy except infection can also cause Quincke's edema (4). In this case, possible reasons of uvular edema are direct trauma of endotracheal tube (ETT), displacement of ETT then pressure on uvula or suctioning trauma.…”

“…Epinephrine causes bronchodil ation and decreases serous secretion in upper and lower airway (4,6). Steroids prevent to mucosal edema by increasing capillary permeability and also have anti-inflammatory effects (6).…”

“…Dexamethasone has long half-life and its anti-inflammatory effect is very strong and it is still essential therapy for uvular edema (7). Diphenhydramine was another option, however, since allergic reaction was not considered, diphenhydramine was not given (4,5). When uvular edema can be related with drug allergic reactions after anesthesia, diphenhydramine can be used (7).…”

Isolated oedema of the uvula induced by intense snoring and ACE inhibitor

“…Lastly, toxic reactions should be ruled out, as not all patients will voluntarily report an exposure to, for instance, cocaine or cannabis (figure 2). 4 14…”