Case Letter

Vibratory Angioedema in a Trumpet Professor

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We present a case of a 38-year-old man, a trumpet professor, who reported pain, swelling, and redness of the upper lip within 20 minutes of playing the trumpet over the last 3 years. No symptoms were noted in his 20-year career. Tingling, swelling, and pain resolved within minutes, hours, and one day of playing the instrument, respectively. Symptoms began shortly after he stopped taking cimetidine for gastroesophageal reflux disease. The severity of symptoms forced the patient to decrease his practice time from 8 hours to less than 20 minutes daily. Changing the mouthpiece from brass to stainless steel or plastic yielded no benefit. The patient also described symptoms of hand swelling after using the lawn mower.


 

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