Angioedema is the sudden swelling or edema of the region beneath the skin or mucosa. It is typically an allergic reaction, similar to urticaria or hives, but it can also be hereditary. The swelling occurs due to the accumulation of fluid, which affects regions with loose tissue, mainly the face, throat, limbs, and genitals. However, it is not uncommon to have urticaria and angioedema at the same time.
Types Of Angioedema
There are four main types of angioedema which include:
Allergic Angioedema: It is the most common type and affects people with an allergy to food, medication, pollen, venom, or animal dander. In very severe cases, there may be an allergic reaction known as anaphylaxis, where the throat may swell making it difficult for the patient to breathe. Blood pressure may drop suddenly, and this would be a medical emergency. Allergic angioedema is not a chronic problem. As soon as the person identifies the trigger causing an allergic reaction, then they can avoid it.
Drug-Induced Angioedema: Certain medications can cause angioedema such as angiotensin-converting enzyme (ACE) inhibitors, a treatment for hypertension. Studies reveal that about 30% of cases of angioedema are associated with the use of ACE inhibitors. In such cases, the healthcare provider may prescribe an alternative medication for treating high blood pressure.
Non-steroidal anti-inflammatory class of drugs (NSAIDs) such as ibuprofen or aspirin is another type of medication that can cause angioedema.
Idiopathic Angioedema: A disease is termed idiopathic if the cause is not clear. In such cases, the doctor may not be able to identify a cause for angioedema, after ruling out all possible causes.
Hereditary Angioedema: Angioedema is inherited, which means it runs in the family. In the case of hereditary angioedema, there is an issue with the C1 inhibitor protein, and the patient will have low levels of the protein C1-esterase inhibitor (C1-1NH protein). In this type, episodes of angioedema will come and go over time.
The swelling deep inside the skin can affect a person in areas including hands, genitals, feet, the lining of the throat and bowel, and the face. Usually, the signs and symptoms appear suddenly and rapidly and remain for up to 3 days, if urticaria develops it may cause itchiness.
In a few cases, the swelling regions may feel hot and painful.
Vision may be affected.
Bronchospasm may develop if the lining of the throat and airways are affected resulting in breathing issues. In severe cases, anaphylactic shock may develop, and this can be life-threatening.
A person may need emergency medical help if:
- Sudden development of angioedema symptoms like an allergic reaction
- Breathing difficulties that are abrupt or are worsening
- Feels dizzy, faint, or collapse
Generally, the cause of angioedema depends on its type:
Insect bites, contact with latex, and certain medications can trigger angioedema.
A gene that causes to produce a low level of a particular protein in the blood can lead to angioedema.
Other triggers include pregnancy, contraceptive pills, infection, or trauma, where patients are given proper treatment in the hospital as episodes may be severe.
In some cases, the exact cause of angioedema is not identified.
Your physician will be able to clearly diagnose the type of angioedema based on the symptoms, and what triggered swelling by getting a detailed family and medical history.
The physician may also recommend the patients to do certain test to confirm the diagnosis, and these include:
A skin prick test to confirm the possible cause of allergies.
Blood works to check how the immune system responds to a certain allergen
A blood test to evaluate C1 esterase inhibitor and a low level suggests that the issue is hereditary.
With proper diagnosis and eliminating allergen, the main aim of the treatment is to avert the recurrence of this condition. The treatment for angioedema depends on the cause, however, it is vital to assure that airway is free. Medicines are suggested to reduce swelling and inflammation such as antihistamines and oral corticosteroids
Drugs are prescribed to slow down your immune system if antihistamines and corticosteroids don’t work.
Blood protein controllers if you have hereditary angioedema.
If angioedema is drug-induced, then your doctor will change to another medicine that help you to manage condition better.