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What is Angioedema?

Angioedema is a condition in which there is a swelling just below the skin in the dermis or the deeper skin tissues. It is generally an immune response to medication, food, pollen, environmental toxins or other allergens. It causes leakage of fluid through the blood vessels in the surrounding tissues causing swelling.

What are the main signs and symptoms of Angioedema?

Swelling on the lips, hands, feet, tongue, and around the eyes occur. Occasionally, an itchy or raised rash called urticaria or hives develops. Pain and mild itching, redness, warmth in the area are the other symptoms that are commonly seen. Oedema or swelling in the respiratory tract causes breathing issues. Oedema in the gastrointestinal tract causes, nausea, vomiting, diarrhoea, or pain.

What are its main causes?

The exact cause of angioedema is unknown. It is usually triggered by an allergic reaction to any allergen like a medication, insect bite, rubber latex, pet dander, or food.

Some medications generally tend to cause oedema. These include angiotensin-converting enzyme inhibitors, non-steroidal anti-inflammatory drugs, and angiotensin receptor blockers.

Some people may inherit angioedema, which may be caused due to genetic modifications.

Few underlying medical conditions, such as infection or leukaemia, can also cause angioedema.

How is it diagnosed and treated?

Initially, doctors will physically examine you based on the symptoms. They may check the affected area and ask you about the medical history or exposure to any allergen. This will help determine the cause. Doctors may further perform some tests for allergies, such as the skin prick test or blood test. Blood testing specifically for C1 esterase inhibitor is performed. Low levels of this substance suggest that the problem is inherited. Abnormal results of tests, such as complement C2 or C4, can be due to an underlying condition.

Based on the cause of angioedema, doctors will prescribe medications. Sometimes, this condition does not require medication and resolves on its own. However, an aggressive form requires specific medical treatment. The main aim is to relieve swelling, itching, and pain.

Medications generally used are anti-itching drugs, anti-inflammatory drugs, drugs that suppress the immune system, drugs that reduce pain and swelling.

If angioedema is caused by an allergic reaction, avoiding the trigger may suffice. Anti-histaminic and steroidal medicines can be used in such conditions.

If angioedema is due to the use of some medications, then talk to your doctor about stopping your medicine and replacing it with a drug that is well tolerated.

Hereditary angioedema cannot be treated, but the symptoms can be treated using medicines that increase the level of C1 esterase inhibitor.

  1. Medicines for Angioedema

References

  1. National Health Service [Internet]. UK; Treatment - Angioedema
  2. MSDmannual consumer version [internet].Angioedema. Merck Sharp & Dohme Corp. Merck & Co., Inc., Kenilworth, NJ, USA
  3. Australasian Society of Clinical Immunology and Allergy. Angioedema. Australia; [internet]
  4. American Academy of Family Physicians. Urticaria and Angioedema: A Practical Approach. Am Fam Physician. 2004 Mar 1;69(5):1123-1129.
  5. Allen P Kaplan. Angioedema. World Allergy Organ J. 2008 Jun; 1(6): 103–113. PMID: 23282406
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