Angioedema 

Introduction 

Swollen lips are a common sign of angioedema 

Anaphylaxis

Angioedema can sometimes occur in combination with anaphylaxis, which is a severe, potentially life-threatening, allergic reaction that can affect breathing.

Signs of anaphylaxis include:

  • breathing difficulties
  • dizziness
  • changes to your skin – such as itchy skin or a raised red skin rash
  • sudden diarrhoea, vomiting and stomach cramps

Anaphylaxis should always be treated as a medical emergency. If you suspect that you, or somebody else, is experiencing anaphylaxis you should immediately dial 999 for an ambulance and tell the operator that you think anaphylaxis has occurred.

Some people with a previous history of anaphylaxis will have an auto-injector of adrenaline. This should be injected into their thigh muscle and held in place for 10 seconds.

Read more about anaphylaxis.

Angioedema is the swelling of the deeper layers of the skin, caused by a build-up of fluid.

The symptoms of angioedema can affect any part of the body, but swelling usually affects the:

  • eyes
  • lips
  • genitals
  • hands
  • feet

Many people with angioedema also have another condition called hives, which is also known as urticaria, welts or nettle rash. This is a raised, red and itchy rash that appears on the skin.

Read more about the symptoms of angioedema.

Why does angioedema happen?

The causes of angioedema depend on the type of condition you have. There are four main types of angioedema:

  • allergic angioedema – the swelling is caused by an allergic reaction, such as a reaction to peanuts, and sometimes occurs in combination with anaphylaxis
  • idiopathic angioedema – there is no known cause for the symptoms of swelling (although certain factors, such as stress or infection, may trigger the symptoms)
  • drug-induced angioedema – the swelling is a side effect of certain medications, most often angiotensin-converting enzyme (ACE) inhibitors
  • hereditary angioedema – the swelling is caused by ‘faulty’ genes that are inherited from a person’s parents

Read more about the causes of angioedema.

How common is angioedema?

Angioedema is quite a common condition which affects about 10-20% of people during their life, although some types are more common than others.

Food allergies, the main cause of allergic angioedema, are estimated to affect about 5-8% of children and 1-2% of adults.

It is not clear how common idiopathic angioedema is, as it can be misdiagnosed as allergic angioedema. However, long-lasting (chronic) idiopathic angioedema is estimated to affect 1 in 2,000 people.

Although estimates vary, ACE inhibitors are thought to cause drug-induced angioedema in around 1-5% of people who take them.

Hereditary angioedema is rare, only affecting between 1 in 10,000 and 1 in 50,000 people worldwide.

Diagnosis

Diagnosing angioedema is relatively straightforward. Due to its distinctive appearance, a doctor should be able to recognise it after a physical examination.

Further tests, such as blood tests, may be required to determine the exact type of angioedema.

Idiopathic angioedema is only diagnosed if no cause can be found after testing.

Read more about diagnosing angioedema.

How is angioedema treated?

Although most cases of angioedema get better without treatment after a few days, medication is often used.

For cases of allergic and idiopathic angioedema, antihistamines and oral steroids (steroid tablets) can be used to relieve the swelling.

Drug-induced angioedema can usually be treated by using an alternative medication to treat whatever underlying condition you have.

Although the condition cannot be cured, regular drug treatment can prevent attacks in people with hereditary angioedema.

Read more about treating angioedema.




Page last reviewed: 25/09/2012

Next review due: 25/09/2014

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Comments

The 6 comments posted are personal views. Any information they give has not been checked and may not be accurate.

pepppy said on 13 September 2014

I was diagnosed with Idiopathic angioedema. Mainly swelling in the throat (although I did get regular tongue swells). It is important to see a specialist to make sure you are on the best meds for your condition. Idiopathic means they don't know what causes the swells but there are triggers. It differs person to person but triggers can be any of the following: food, stress, tiredness to name a few!

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junkdog said on 20 February 2013

hi i have idiopathic angioedema and it only started about 4 years ago just came out the blue at the age of 44 have seen all the doctors had too many tests to count and nothing they can't find the cause, i get mainly tongue swelling with the occaisional face swelling get it twice a week every 2 weeks like clockwork i take prednisone and also 2 cetrizine every morning and 1 cetrizine every night, i don't feel it does alot for me eccept stop me getting hives as when i stop the pills i get hives which i never used to get.i do my own blog its actually about building and home improvements nothing to do with this but i have dedicated a page on telling my story and have included pictures of my different swellings i am going to start putting different things and ideas of what other people are doing, please have a look and leave comments to help others at http://www.junkdog.co.uk/angioedema-hives/ thanks darren

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Wanderer21 said on 19 November 2012

Camaraderie, I was very interested in your comment. I have had idiopathic angioedema since my first episode in 1999. It started out being rare but now has increased to about 2-3 bouts per month, mainly my eyes and facial area. I, too, have gone through all the allergy testing plus years of my own research, cutting out of food additives, colouring, etc., with no results. I now take prednisone as soon as I feel the symptoms starting and that usually keeps it under control. I alwo take Reactine every morning and Benadryl every night to help. My symptoms seldom last more than 24 hours as well. The only factor that I have found to contribute to episodes is my night shifts and that's because my doctor said that's when my immune system is run down due to fatigue. But I work shift work so there is nothing I can do about that. I am very hesitant to go on anti-depressants (what kind worked for you?) because I hate taking unnecessary meds but the thought of only having swelling once a year is more appealing than I care to mention! Are you still taking it and do you have any side effects from it?
Thanks!

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Camaraderie said on 09 October 2012

Thats fine if the medical profession have any answers. I have suffered from idiopathic angioedema for 25 years, undertaken every allergy test and not found the cause. I have been taking 2 prescribed antihistimines every day which has helped to reduce the attacks to 2-3 per month. By sheer luck & perserverence I think I have found my solution, I started taking an anti-depressant 50 mg/day in November 2011 and have only had 1 attack in 10 months. The sertraline has reduced my stress and I guess the angioedema. Hope this helps any other desperate & frustrated sufferer.

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HAE UK said on 02 May 2011

Are you awrae of the new patient assocation HAE UK?
Here is the link to our recent newsletter.
http://www.haei.org/sites/default/files/public/HAEUK_NEWS_2.pdf

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nicko678 said on 22 June 2010

My wife was diagnosed with this condition about 6 months ago, and she was directed to use over the counter hystamines by our doctor.

These anti hystamines work very effectively for her, and I would advise anyone reading this to take advice from their doctor rather than thread comments!!

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