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. 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. Seek immediate medical care (call 911) if angioedema becomes severe. This means the condition begins to cause swelling in the area of your throat or mouth; you experience dizziness or fainting, difficulty swallowing, difficulty breathing; or you experience chest pain or pressure.

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

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

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

In some cases, angioedema can be life threatening. Seek immediate medical care (call 911) for any of these life-threatening symptoms:

• abdominal pain or cramping
• chest pain or pressure
• difficulty breathing
• difficulty swallowing
• dizziness
• severe sudden swelling

Angioedema is generally a result of an allergic reaction, such as those due to food or medication allergies. Rarely, it can be hereditary. In some cases, the cause of angioedema may not be found.

Angioedema may develop after an infection or in association with a chronic disease, such as lupus or certain cancers.

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

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

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

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.

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

Treatment options for angioedema include:

• antihistamines (either over-the-counter or prescription, depending on the severity of your angioedema)
• corticosteroids to decrease inflammation
• epinephrine (adrenaline) for severe reactions
• application of a cool, wet cloth to the affected areas

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

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 a doctor determines the underlying cause, you can help minimize your risk of serious complications by following the treatment plan you and your healthcare professional design specifically for you.

Complications of angioedema include:

• anaphylaxis (life-threatening allergic reaction)
• difficulty breathing
• unconsciousness and coma