# Tramadol-Induced Fatal Angioedema: A Rare Case

## TL;DR

This paper reports a rare case of fatal angioedema caused by tramadol in a patient with systemic lupus erythematosus.

## Contribution

The novelty lies in documenting a rare and fatal case of tramadol-induced angioedema in a patient with SLE.

## Key findings

- Tramadol-induced angioedema is extremely rare but can be fatal.
- Underlying conditions like SLE may increase the risk of tramadol-induced angioedema.
- The case highlights the need for caution when prescribing tramadol to patients with SLE.

## Abstract

Angioedema is a non-pitting edema that involves the subcutaneous and submucosal layers of the face, lips, neck, oral cavity, larynx, and gut. It may become life-threatening when it involves tissues of the larynx. Angioedema can be triggered by exposure to drugs such as angiotensin-converting enzyme inhibitors (ACE inhibitors), opioid drugs, and nonsteroidal anti-inflammatory drugs (NSAIDs). Tramadol is an opioid analgesic medication that may also induce angioedema, but the incidence of tramadol-induced angioedema is very rare in literature to date. It has been postulated that tramadol may cause fatal angioedema in the presence of underlying diseases such as systemic lupus erythematosus (SLE) or concomitant drugs such as NSAIDs. We describe the case of a patient with SLE who experienced fatal angioedema following tramadol intake.