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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Swollen Tongue Since Thyroid Removal, Deep Ridges On Edges, Normal Results For Tongue Biopsy. Any Suggestions?

I have a swollen tongue since thyroid removal. Thyroid tests come back in norman range. I have been tested for amyloidosis and that all came back okay. That even included a tongue biopsy . Nothing can be found for a cause, but it is very annoying and painful at times. I do have deep ridges on the edges of my tongue from my teeth. Have also been to a dentist . I don t know the next step in finding a cause. Any suggestions?
Wed, 25 Sep 2013
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Allergist and Immunologist,  's  Response
Hello,

I hope the test for amyloidosis was a rectal biopsy with Congo Red stain that is still the gold standard.
The other option is angioedema of tongue secondary to medications like lisinopril or captopril etc (ACE-inhibitor group of drugs for controlling blood pressure).
It is not an allergy to the drug but rather a buildup of chemicals that cause swelling.

The 3rd possibility is consumption of C4 protein, that should be checked with serum Complement C4 levels (just a blood test). If very low, you need additional scans like US or CT abdomen to exclude a secondary cause of low C4 levels.

I hope that was useful.
Best Wishes.
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Swollen Tongue Since Thyroid Removal, Deep Ridges On Edges, Normal Results For Tongue Biopsy. Any Suggestions?

Hello, I hope the test for amyloidosis was a rectal biopsy with Congo Red stain that is still the gold standard. The other option is angioedema of tongue secondary to medications like lisinopril or captopril etc (ACE-inhibitor group of drugs for controlling blood pressure). It is not an allergy to the drug but rather a buildup of chemicals that cause swelling. The 3rd possibility is consumption of C4 protein, that should be checked with serum Complement C4 levels (just a blood test). If very low, you need additional scans like US or CT abdomen to exclude a secondary cause of low C4 levels. I hope that was useful. Best Wishes.