58 year old physician, male, hypertensive and diabetic for last 7 yrs (well controlled with metformin, glimiperide, voglibose, metoprolol, ramipril, aspirin and atorvastatin) has been suffering from recurrent attacks of choking sensation in the throat at night awakening from sleep. No wheeze, cough, dysphagia, fever etc, sometimes mild pain. On self examination with torch and mirror, membranous swelling of uvula and anterior palatopharyngeal fold hanging from posterior pillar of tonsil and soft palate on right side and sometimes on left side. There is symptomatic relief with paracetamol, antihistamines and warm saline gargle and after 4-6 hrs no trace of the swelling could be found by the ENT specialist.
Sometimes small white membrane was seen on the uvula and soft palate. Could it be food or drug allergy or otherwise? Ramipril was withdrawn.
