What is Angioedema?

Angioedema is a potentially serious medical condition, related to hives. Angioedema may include large welts on the skin forming a rash, which can be itchy, warm feeling, and/or painful.

Affected areas are often swollen, with the swelling at a deeper layer of the skin than in the case of hives, and also sometimes occurring internally.

Externally, angioedema occurs most often on the face around the eyes and lips, and is also fairly common on the neck, hands, feet, and genitals. Internally, typical locations of swelling are in the throat, mouth, intestines, and bowels.

Internal swelling from angioedema can be particularly dangerous. Swelling in the digestive track can cause severe abdominal pain due to cramping.

Swelling of the throat, tongue and lungs can impair breathing, leading to respiratory discomfort, lightheadedness, loss of consciousness, and even death.

Like hives, angioedema is the body’s reaction to the release of histamine and other chemicals into the bloodstream. Most often this is an allergic reaction.

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Common allergens that can cause an outbreak of hives or angioedema include foods such as milk, peanuts or shellfish, medications such as aspirin, ibuprofen or penicillin, and other substances such as latex, pet dander or pollen.

In addition to allergies, other possible triggers for hives or angioedema include exercise, heat or stress, as well as certain medical conditions and treatments such as cancer, lupus or blood transfusions.

There is also a rare hereditary form of angioedema, where the person has low levels or abnormal functioning of C1 inhibitor blood proteins. An outbreak of hereditary angioedema is usually not accompanied by a hives-like rash.

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In diagnosing angioedema, a doctor will attempt to ascertain what is triggering the outbreaks.

The patient can assist the process by keeping written records of outbreaks, along with what other possibly relevant factors were present at that time, such as a new pet introduced into the home, a change in cosmetics used, some new vitamin supplement, a shellfish meal, etc.

The doctor may also perform an allergy skin test, where tiny portions of purified allergen extracts are placed on the skin or injected under the skin, to see if the patient reacts to any of them.

A doctor who suspects hereditary angioedema may also perform blood tests to check the levels of the relevant blood proteins.

Hives and angioedema are typically treated with antihistamines-prescription or non-prescription-to reduce the itching and swelling. Because angioedema can be more severe, a doctor may prescribe a corticosteroid drug.

In an emergency situation where the patient is unable to breathe, an injection of epinephrine may be necessary.

Hereditary angioedema is less likely to respond to antihistamines or corticosteroid. In that case, doctors will sometimes prescribe androgens, or medications such as Berinert, Cinryze or Ecallantide that help to regulate the levels of blood proteins.

Usually angioedema will clear up without leaving any permanent marks or disfigurement. Many outbreaks are quite mild. However, due to its potential to obstruct breathing, it must be taken very seriously.

A person who experiences chest tightening, difficulty breathing, throat swelling or lightheadedness should seek emergency treatment immediately.

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