Massive tongue swelling following the use of synthetic saliva.

A 5-year-old boy with cerebral palsy and severe learning difficulties developed massive tongue swelling of sudden onset following the use of synthetic saliva. Acute airway obstruction and severe stridor ensued which required tracheal intubation and transfer to paediatric intensive care. The child was treated with intravenous steroids, antihistamines and epinephrine. With cessation of synthetic saliva, the swelling gradually resolved and the child was extubated on day 5.