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by McCoy K
(Angioneurotic Edema; Hereditary Angioedema)

Definition

Angioedema is swelling under the surface of the skin with or without redness. It is very common. Angioedema can occur around the eyelids and lips, or on the face, hands, feet, or genitalia. It can also cause swelling of the airways, so it is important to seek medical care.

Causes

Angioedema is often associated with hives . It can be caused by:

  • Foods such as fruits, shellfish, and nuts
  • Medicine such as nonsteroidal anti-inflammatory drugs (NSAIDs), angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB) inhibitors, penicillin, aspirin, and morphine
  • Infections
  • Inhaled irritants such as pollens, mold spores, and animal dander
  • Certain diseases such as hyperthyroidism , cancer, and rheumatic fever
  • Cold or hot environments
  • Skin contact with plants, animals, or some medicine
  • Skin disease
  • Family history
Hives
Splotchy body rash -adult
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Risk Factors

This condition is more common in women and people who are 30 to 60 years of age. Things that may increase the risk of angioedema are:

Symptoms

Symptoms may include:

  • Large swelling with unclear borders around the eyelids and lips
  • Lesions on the face, trunk, genitals, and extremities
  • Swelling of the hands and feet
  • Swelling of the throat
  • Abdominal pain
  • Rash that is not itchy

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done. The doctor may ask about any medicine you have taken or recent activity. The diagnosis can often be made by sight. Tests may be done if causes are not clear and it recurs.

Treatment

Minor angioedema may not need treatment. However, it is important to make sure the swelling does not spread to the airway. Symptoms can be eased with medicine such as:

  • Antihistamines—can ease swelling and itching.
  • Corticosteroid drugs—to ease swelling.
  • Epinephrine—fast-acting medicine to ease swelling in severe reactions. This medicine can be carried for emergency use for future events.

It is important to learn what the trigger was. Avoiding the trigger can prevent or reduce future events.

Severe swelling can close off the airway. A small opening may need to be made in the neck. It will create a new airway until the swelling has passed.

Tracheostomy Tube
Tracheostomy Tube
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Prevention

Avoid triggers to reduce chance of more events.

RESOURCES

American Academy of Allergy, Asthma & Immunology  http://www.aaaai.org 

Asthma and Allergy Foundation of America  http://www.aafa.org 

CANADIAN RESOURCES

Canadian Dermatology Association  https://dermatology.ca 

Canadian Society of Allergy and Clinical Immunology  http://csaci.ca 

References

Acute urticaria. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T916900/Acute-urticaria  . Updated July 27, 2017. Accessed February 7, 2020.

Tarbox J, Bansal A, Peiris A. Angioedema. JAMA. 2018;319(19):2054. Accessed at: https://jamanetwork.com/journals/jama/fullarticle/2681197.

Angioedema. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/condition/angioedema/  . Updated March 19, 2019. Accessed February 7, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 09/2019
  • Update Date: 02/07/2020