RESUMO
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. Both episodes occurred following intranasal cocaine use. Examination revealed an enlarged uvula obstructing the airway. The patient was treated with epinephrine, antihistamines, and corticosteroids with resolution of the uvular edema. This case highlights the importance of considering cocaine as a potential causative agent in isolated uvular angioedema and emphasizes the need for patient education to avoid further cocaine use.
RESUMO
Euglycemic diabetic ketoacidosis (euDKA) is a rare but serious adverse effect caused by sodium-glucose cotransporter-2 (SGLT2) inhibitors, and it can be challenging to identify in the emergency room (ER). In this report, we present a case of a type 2 diabetic patient whose diagnosis was delayed due to the absence of marked hyperglycemia. A 39-year-old female presented to the ER with a four-day history of nausea, vomiting, sweating, dyspnea, and generalized weakness after initiating dapagliflozin, along with a low carbohydrate diet and moderate exercise to curb her newly diagnosed type 2 diabetes mellitus (DM). However, this had resulted in strict avoidance of carbohydrates. Despite seeking medical attention twice, a proper diagnosis had been delayed due to the absence of marked hyperglycemia. Her blood glucose level at our hospital was 181 mg/dl and urine analysis showed ketonuria and glucosuria. She was admitted to the ICU with a diagnosis of euDKA related to SGLT2 inhibitor use. She was successfully treated with insulin and glucose supplementation.