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Penicillin, Entonox or bupivacaine seemed possible cause of the Quincke's disease. Hereditary form was ruled out by normal creatine kinase and reaction to bupivacaine by C1 esterase inhibitor assay. It can be associated with spectrum of anaphylactic reactions and the resuscitation team should be alerted. Airway maintenance should be the primary management strategy. Most cases respond to observation, oxygen therapy and antihistamines with or without steroids. 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