SHM Converge Scientific Abstract ePoster Gallery-A Rare Case of Zolmitriptan-Induced Angioedema With Atypical Presentations

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This case describes a 46-year-old woman who developed sudden dysphagia, left neck swelling, and syncope after drinking coffee. Imaging showed extensive transient soft-tissue edema extending from the left neck into the mediastinum and multiple abdominal/retroperitoneal regions. Her symptoms and radiologic findings resolved spontaneously within hours to a day, but the cause was initially unclear.<br /><br />Laboratory tests were largely normal, including C1-inhibitor activity, making hereditary angioedema unlikely. She had no history of ACE inhibitor or NSAID use. After discharge, she later had a second brief episode of right elbow swelling and throat tightness. Careful re-questioning revealed that she had taken zolmitriptan before both attacks. Based on prior reports of triptan-associated angioedema, the final diagnosis was zolmitriptan-induced angioedema.<br /><br />The diagnosis was delayed because the patient did not initially report her as-needed migraine medication, and the symptoms appeared several hours after drug use, making the connection less obvious. In addition, angioedema caused by triptans is rare and not widely recognized.<br /><br />After she was instructed to avoid zolmitriptan, no further episodes occurred. This case highlights that even uncommon medications taken intermittently should be included in a thorough medication history when evaluating unexplained angioedema, especially when symptoms are transient and atypical.

Asset Subtitle

Yuto Unoki

Meta Tag

Author List Yuto Unoki

Category Clinical Vignettes

Concept Angioedema

Concept Medication History

Concept Hereditary Angioedema

Concept Localized Swelling

Concept Zolmitriptan

Distinguished Non-Finalist

Presenter Organization Iizuka Hospital,General Internal Medicine

Presenting Author Yuto Unoki

Track Adult

Keywords

zolmitriptan

angioedema

dysphagia

syncope

neck swelling

triptan-induced angioedema

migraine medication

soft-tissue edema

medication history

transient symptoms

Angioedema

Medication History

Hereditary Angioedema

Localized Swelling

Zolmitriptan