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Objective: To report a case of drug-induced isolated angioedema secondary to the use of Entresto (Valsartan/Sacubitril).

Case Summary: A 75-year-old White man presented with swelling of the uvula with a normal tongue shape and gradual onset of speech difficulty, shortness of breath, and difficulty swallowing after taking his chronic medication Entresto (sacubitril/valsartan). The main possibility considered was uvular angioedema, other potential causes were not identified.

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Isolated uvular angioedema, or Quincke's disease, is a rare manifestation with various potential causes. This article presents the first documented case of recurrent isolated uvular angioedema associated with intranasal cocaine use. The patient, a 43-year-old man, exhibited acute symptoms of sore throat, throat swelling, and difficulty breathing, with a history of a similar episode a few years prior.

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Quincke's disease is a very rare form of upper airway angioedema, and it is characterized by a well-localized edematous reaction. Its epidemiology is not documented due to the rarity of this condition. Causes include allergic reactions, infectious diseases, and trauma, among others.

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A 34-year-old male presented as an emergency with sudden onset globus, stertor and choking whilst asleep. He had similar previous episodes that self-resolved. The patient's observations were all within normal range.

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Assessment of ED triage of anaphylaxis patients based on the Emergency Severity Index.

Am J Emerg Med

August 2021

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States of America. Electronic address:

Objectives: To describe the emergency department (ED) triage of anaphylaxis patients based on the Emergency Severity Index (ESI), assess the association between ESI triage level and ED epinephrine administration, and determine characteristics associated with lower acuity triage ESI assignment (levels 3 and 4).

Methods: We conducted a cohort study of adult and pediatric anaphylaxis patients between September 2010 and September 2018 at an academic ED. Patient characteristics and management were compared between Emergency Severity Index (ESI) triage level 1 or 2 versus levels 3 or 4 using logistic regression analysis.

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