What causes facial and tongue swelling

Tongue swelling

Synonym: tongue edema
English: tongue swelling, tongue (o) edema

1 definition

Under the term Tongue swelling one understands the edematous enlargement of the tongue, which often occurs acutely and recurs.

2 etiopathogenesis

Tongue swelling can have a number of causes.

2.1 Hereditary angioneurotic edema

Hereditary angioneurotic edema is based on a quantitative or functional deficiency of the C1 esterase inhibitor (C1-INH). The lack of C1 esterase inhibitor leads to swelling of the tongue, e.g. in the case of infections or trauma. In addition, swelling of the lips and larynx can be observed. Swelling of the lining of the intestines can lead to an acute abdomen.

2.2 Quincke's edema

In Quincke's edema, the exact cause of the swelling is not known. Psychological and physical traumas promote the development.

2.3 allergy

Tongue swelling is also possible if you are allergic to food. The swelling can also occur as a remote reaction in the event of a cross allergy between pollen and food.

2.4 Medicines

Therapy with ACE inhibitors can also lead to allergic swelling of the tongue.

3 diagnostics

The diagnosis depends on the suspected diagnosis. If an allergy is suspected, a detailed anamnesis should be taken and allergy diagnostics (e.g. prick test, determination of specific IgE antibodies in the blood) carried out.

If hereditary angioneurotic edema is suspected, the amount of C1 esterase inhibitor and complement factors 2 and 4 in the blood are determined.

If Quincke's edema is suspected, a detailed anamnesis and, if necessary, further examinations (allergy diagnostics, microbiological diagnostics, laboratory tests) should be carried out.

4 therapy

Quincke's edema is treated with corticosteroids and antihistamines.

In the case of hereditary angioneurotic edema, the C1 esterase inhibitor can be administered in the acute stage. Testosterone can have a prophylactic effect.

In the case of an allergic tongue swelling, antihistamines have a prophylactic and symptomatic effect. Corticosteroids and adrenaline are used as acute therapy. Allergen avoidance is - as far as practicable - obligatory.