Angioedema: Symptoms, Causes, Treatment

What are the symptoms of angioedema?

Angioedema is a condition characterized by sudden swelling beneath the skin or mucous membranes, often caused by an allergic reaction or other factors. The symptoms of angioedema include:

1. Swelling: Rapid swelling of the skin, often around the eyes, lips, tongue, throat, hands, feet, or genitals. The swelling may be asymmetric and not involve itching.
2. Pain or tenderness: The swollen areas may feel tender or painful, and the skin may feel warm to the touch.
3. Difficulty breathing: Swelling in the throat or tongue can cause difficulty breathing, which is a medical emergency.
4. Abdominal pain: If the gastrointestinal tract is affected, symptoms can include severe abdominal pain, cramping, and sometimes nausea and vomiting.
5. Hives: In some cases, angioedema is accompanied by hives (urticaria), which are raised, red, itchy welts on the skin.
6. Swelling of the larynx: This can cause hoarseness or stridor (a high-pitched wheezing sound) and is also a medical emergency.
7. Fatigue or general malaise: Some people may experience a general feeling of being unwell or fatigue.

Angioedema can occur in response to allergens, medications (like ACE inhibitors), infections, or can be hereditary. It is important to seek immediate medical attention if there are symptoms involving breathing difficulties or swelling of the throat, as these can be life-threatening.

What are the causes of angioedema?

Angioedema can have various causes, including:

1. Allergic reactions: Angioedema is often triggered by an allergic reaction to certain foods (such as nuts, shellfish, or eggs), medications (such as antibiotics or nonsteroidal anti-inflammatory drugs), insect stings or bites, or other allergens.
2. Hereditary angioedema (HAE): This is a rare genetic condition caused by a deficiency or dysfunction of a protein called C1 inhibitor. It leads to recurrent episodes of swelling, often without an identifiable trigger.
3. Acquired angioedema (AAE): Unlike HAE, AAE is not inherited but acquired later in life due to conditions such as autoimmune diseases (like lupus), certain cancers (such as lymphoma), or as a side effect of medications like ACE inhibitors.
4. Idiopathic angioedema: In some cases, the cause of angioedema remains unknown, and it is referred to as idiopathic angioedema.
5. Physical stimuli: Some individuals may experience angioedema in response to physical stimuli such as pressure on the skin (dermatographism), cold temperatures (cold-induced angioedema), or exposure to sunlight (solar urticaria).
6. Infections: Certain infections, such as viral or bacterial infections, can trigger angioedema in susceptible individuals.
7. Underlying medical conditions: Angioedema can be associated with underlying medical conditions such as thyroid disease or mast cell disorders.
8. Stress: Emotional stress or physical stressors can sometimes trigger episodes of angioedema in susceptible individuals.

Determining the underlying cause of angioedema is important for appropriate management and treatment. If someone experiences recurrent episodes of angioedema, it’s essential to consult a healthcare professional for evaluation and diagnosis.

What is the treatment for angioedema?

The treatment for angioedema depends on its underlying cause and severity. Here are some common approaches:

1. Antihistamines: For allergic angioedema, especially mild cases, antihistamines like cetirizine, loratadine, or diphenhydramine can help relieve itching and reduce swelling by blocking the effects of histamine.
2. Epinephrine: In severe cases of allergic angioedema, especially those involving difficulty breathing or swelling of the throat, epinephrine may be administered as an emergency treatment to rapidly reverse symptoms and prevent anaphylaxis.
3. Corticosteroids: Oral or intravenous corticosteroids like prednisone or methylprednisolone may be prescribed to reduce inflammation and swelling, especially for moderate to severe cases of angioedema.
4. Medications for hereditary angioedema (HAE): Patients with HAE may require specific medications to prevent or treat attacks, such as C1 inhibitor replacement therapy (e.g., Berinert, Cinryze), kallikrein inhibitors (e.g., ecallantide), or bradykinin receptor antagonists (e.g., icatibant).
5. Avoidance of triggers: If angioedema is triggered by certain foods, medications, or other allergens, it’s important to identify and avoid these triggers to prevent future episodes.
6. Treatment of underlying conditions: If angioedema is secondary to an underlying medical condition or medication, addressing the underlying cause may help manage symptoms.
7. Supportive care: In cases of angioedema involving respiratory distress, supportive measures such as oxygen therapy, airway management, and close monitoring may be necessary.
8. Stress management: For idiopathic or stress-induced angioedema, stress management techniques such as relaxation exercises, counseling, or mindfulness practices may be beneficial.

It’s crucial for individuals experiencing angioedema to seek medical attention, especially if symptoms are severe or involve difficulty breathing or swelling of the throat, as these can be life-threatening emergencies. A healthcare professional can provide a proper diagnosis and recommend appropriate treatment based on the specific circumstances.