Angioedema

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Introduction

What is angioedema?

Angioedema is a localized tissue swelling similar to hives in which areas of raised, itchy skin appear. However, in contrast to hives, which appear on the surface of the skin, angioedema affects deeper layers of the skin and other organs (mouth, airways, intestinal tract, etc.). Angioedema may occur anywhere, but most commonly affects the skin around the eyes and around and in the mouth.

Angioedema is generally a result of an allergic reaction, such as those due to food or medication allergies. Rarely, it can be hereditary. Angioedema may develop after an infection or in association with a chronic disease such as lupus or certain cancers. Since it is typically due to an allergic reaction, anyone can experience angioedema. The severity of angioedema is variable. Mild cases may not require medical treatment, but severe cases can lead to life-threatening consequences such as difficulty breathing.

Treatments for angioedema can include steroids, antihistamines, epinephrine and other medications. In life-threatening cases, respiratory support, such as a breathing machine, may be necessary. In milder cases that do not compromise breathing, angioedema is not usually a serious condition and resolves on its own within a few days.

While generally not a serious condition, angioedema can sometimes be life threatening. See k immediate medical care (call 911) if angioedema becomes severe and begins to cause swelling in the area of your throat or mouth or you experience dizziness or fainting, difficulty swallowing, difficulty breathing, or if you experience chest pain or pressure.

If you experience persistent angioedema (more than several days), are in pain, or your angioedema causes you concern, s eek prompt medical care.

Symptoms

What are the symptoms of angioedema?

Symptoms of angioedema generally include skin symptoms that resolve within several days. However, severe angioedema can be persistent and lead to more severe symptoms.

Common skin symptoms associated with angioedema

You will likely experience angioedema symptoms daily during the course of your condition. At times any of these symptoms can be severe:

  • Hives (urticaria)
  • Itchy skin
  • Pain over the affected area
  • Redness, warmth or swelling of the skin
  • Sensitivity to touch in the affected area

Serious symptoms that might indicate a life-threatening condition

In some cases, angioedema can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:

Causes

What causes angioedema?

Angioedema is most frequently caused by an allergic reaction. As part of that reaction, your body will release histamine, a chemical that causes swelling. Alternatively, your angioedema may be hereditary and caused by gene mutations. In some cases, the cause of angioedema may not be found.

Common causes of angioedema

Nonhereditary angioedema may be caused by a variety of conditions or events including:

  • Allergies, including those to dander, foods (for example, nuts and shellfish), medications (for example, ACE inhibitors or penicillin), pollen, and bites or stings
  • Strenuous prolonged exercise
  • Stress

Less common causes of angioedema

Nonhereditary angioedema is less frequently caused by more serious underlying conditions or diseases including:

  • Bacterial or viral infections leading to diseases such as hepatitis
  • Cancer, such as lymphoma or leukemia
  • Systemic lupus erythematosus (disorder in which the body attacks its own healthy cells and tissues)
  • Thyroid conditions

What are the risk factors for angioedema?

A number of factors increase the risk of developing angioedema. Not all people with risk factors will get angioedema. Risk factors for angioedema include:

  • Allergies
  • Personal or family history of angioedema
  • Underlying disorder such as lupus, lymphoma, or thyroid disease

    Reducing your risk of angioedema

    Angioedema is most frequently the result of an allergic reaction. Therefore, avoiding known allergens is the best way to reduce your risk of developing angioedema.

    Treatments

    How is angioedema treated?

    Angioedema is typically not a serious condition and will usually resolve on its own without treatment. If severe enough to cause breathing difficulties, hospitalization and respiratory support are necessary.

    Treatment options for angioedema

    Treatment options for angioedema include:

    • Administration of antihistamines (either over-the-counter or prescription, depending on the severity of your angioedema)

    • Administration of corticosteroids to decrease inflammation

    • Administration of epinephrine (adrenaline) for severe reactions

    • Application of a cool, wet cloth to the affected areas

    Long-term treatment for angioedema

    Depending on the specific cause of your angioedema, you may be able to control the frequency and severity of your angioedema episodes by participating in long-term treatment plans including:

    • Going through desensitization therapy, which involves taking increasing doses of medication

    • Taking a nightly low dose of an antihistamine

    What are the potential complications of angioedema?

    Although it may be a mild condition, it is possible for persistent or severe angioedema to lead to severe and life-threatening complications. Additionally, hereditary angioedema typically produces more severe episodes than allergic angioedema, which may also lead to complications. Therefore, it is important for you to seek medical consultation if your angioedema is persistent or severe in order to identify the underlying cause. Once the underlying cause is determined, you can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of angioedema include:

    • Anaphylaxis (life-threatening allergic reaction)

    • Difficulty breathing

    • Unconsciousness and coma

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    Medical Reviewer: William C. Lloyd III, MD, FACS
    Last Review Date: 2019 Jan 4
    1. Angioedema. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001849/.
    2. Allergic reactions: Tips to remember. American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/patients/publicedmat/tips/whatisallergicreaction.stm.
    3. Kaplan AP, Greaves MW. Angioedema. J Am Acad Dermatol 2005; 53:373.
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