HWN Suggests

Uvular Edema

Frequently, cases are treated with a shotgun approach where patients are treated with epinephrine, steroids and antihistamines. In cases of hereditary angioedema there are now a number of FDA-approved medications that act by replacing C1 esterase inhibitor (C1-INH), inhibiting kallikrein mediated breakdown of high molecular weight kininogen (HMWK) into bradykinin or inhibiting the bradykinin B2 receptor. Despite case reports and case series none of these have been shown to be effective in ACE inhibitor induced angioedema. Fresh frozen plasma contains both C1-INH and angiotensin converting enzyme (ACE, also known as kininase II), which may help to reduce the swelling associated with bradykinin-mediated…

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Articles of Interest

Uvulitis

Recently, one of my esteemed colleagues, Dr. Christyn Magill, asked whether a markedly swollen uvula would make me consider something more ominous… and I cavalierly said, “I’m sure it’s just a virus.” Fortunately, my less than thoughtful response seems to have been correct… but let is take a minute to see how wrong I could have been. Let’s review the potential associations of Uvulitis... Most often management is symptomatic.

Uvulitis caused by parainfluenza virus

Since Hib infections have been nearly eradicated due to vaccination efforts, it is reasonable to assume that viral infections are a primary consideration among children who are completely vaccinated against Hib presenting with uvulitis and a negative antigen test for GAS. Nowadays, broad-spectrum antibiotics may not be necessary.

What's the Weirdest Health Problem You've Ever Had? (I'm Back With a Doozie of a Story!

Uvulitis is simply a very angry, swollen uvula. It's relatively rare, I was told, but it can flare up for a variety of reasons, the most common being a virus. Since I had body aches, this seemed to confirm things for me. The problem with uvulitis, though, is that it doesn't go away quickly, and there's not magic pill to cut the pain (really, I tried everything).

A Concerning Uvula Abnormality

An oropharynx examination revealed a thin strand of tissue connecting the tip of her uvula to the base of her tongue. No cervical lymphadenopathy was noted, and the rest of her examination was unremarkable. Given the patient’s history and examination findings, the growth was consistent with squamous papilloma of the uvula, especially with the visual formation of the bridge of tissue.

Acute Angioedema of the Uvula

Spontaneous swelling of the uvula is actually quite common, its etiology is usually obscure, and it's unclear whether any treatment alters the clinical course. Most cases are mild and annoying but rather inscrutable. When the cause is noninfectious angioedema, the uvula resembles a large white grape (termed uvular hydrops). Usually the laboratory is of no value...

Anaphylaxis Presenting as Uvulitis

This case describes a patient who presented with uvulitis significant enough to cause marked airway compromise. Emergency management of this condition as anaphylaxis resulted in prompt resolution of his symptoms without the development of a biphasic component. Anaphylaxis remains an under-recognized problem, despite being life-threatening.

Big Uvula?

Even though some people claim that the uvula, the fleshy extension of tissue that hangs down from the middle of the soft palate, can affect speech and swallowing, this is false. Like the appendix, the uvula is a vestigial structure with no function; it doesn’t cause symptoms unless it gets very swollen; and then it can cause a lump-in-the-throat sensation, throat irritation, snoring, choking episodes, and chronic cough.

Isolated uvular angioedema: Quincke’s disease

In spite of being a rare condition, uvular edema may cause obstructive respiratory distress and require immediate airway care. The general treatment strategies in the emergency department consist of intravenous H1 and H2 histamine blockers, corticosteroids and infrequently epinephrine. Dexamethasone has been considered the medication of choice considering its potent anti-inflammatory properties and long half-life.

Know about Uvulitis

Although generally not a severe health concern, uvulitis can be uncomfortably pronounced and might hint at an underlying issue. Uvulitis can occur due to various reasons, with the most common being infection. Bacterial or viral infections can lead to inflammation of the uvula. Additionally, irritants such as smoking, excessive alcohol consumption, or exposure to dry air may contribute to uvulitis. Allergies and certain medical conditions, like acid reflux or snoring, can also be associated with inflammation of the uvula.

Quincke’s disease

Quincke’s disease usually presents with a foreign body sensation in the throat in a previously well patient. Fever and pain are frequently absent. The uvula is oedematous and it can compromise the airway rapidly and lead to potentially a life-threatening situation so assurance of a patent airway is of paramount importance.

Quincke’s disease: an unusual pathology

The term Quincke’s disease is used to describe a phenomenon where a patient experiences isolated angioedema of the uvula. It is a rare clinical diagnosis and as a consequence, its epidemiology has not been documented in the literature. The primary concern when a patient presents with Quincke’s disease is a threatened airway. If the airway is compromised, then initial management must be focused on restoring a safe airway.

Quincke’s Disease: Isolated Uvulitis

Uvulitis can be caused by mechanical trauma, chemical or thermal injury, infection, or angioedema of immunologic or non-immunologic origin.

Say Ah The Unexpected Uvula

Although bifid uvula is in itself a benign finding and should not be treated, its association with recurrent infections and arterial aneurysms may be significant.

Resources

10 Reasons You Should Never Ignore a Swollen Uvula, According to Doctors

That dangly thing in the back of your throat (a.k.a. your uvula) is pretty important—it helps you swallow your food, allowing you to eat and speak properly. But, you probably don’t think about it much unless you notice you have a swollen uvula, or uvulitis. Like a swollen tongue or swollen feet, your uvula can balloon for a number of reasons, so we tapped the experts to find the most common causes.