Angioedema is an allergic reaction that causes swelling beneath the skin’s surface and is usually evident on the eyes, lips, hands, feet, tongue and throat. The genitals could be affected as well. The condition generally develops within minutes or hours following exposure to the allergen and might only affect one part of the body. This form of allergic reaction could be associated to an autoimmune disorder.
Angioedema can be severe and needs prompt medical intervention. Severe allergic reaction causes breathing troubles and treatment is usually aimed at clearing the airways to help the victim breathe properly. Patients are treated based on the severity of their symptoms. It would also be of great help if the patient knows the allergen that triggered the reaction and avoid being exposed to it in the future.
What is Angioedema?
Angioedema develops as a result of fluid buildup deep down the dermis or subcutaneous and submucosal tissues. A naturally-occurring substance called histamine has a lot to do with this. This substance is produced by basophils and mast cells when the body senses foreign invaders or allergens. Histamine causes the blood vessels to expand and become more permeable. This results in extracellular gaps to form in the tissues, thereby allowing excess fluid to seep through and accumulate. This is the reason why the affected area appears swollen and red.
Classification of Angioedema
There are different classifications of angioedema and these are:
This arises when the person is allergic to certain foods like milk, eggs, berries and seafood; medicines like aspirin, NSAIDs and penicillin; insect bites and even latex. Allergic reactions could likewise be caused by pollens and animal dander.
Deep swelling in the skin can be triggered by some drugs or medications. Hypertension medications, like angiotensin-converting enzyme inhibitor is notorious for causing swelling. It could also be induced by vaccines, COX-II inhibitors, statins, proton pump inhibitors and bupropion.
The affected individual may have inherited a defective or mutated gene from one or both of his or her parents. The gene in question is the C1-INH which is responsible for producing a protein that controls the immune system.
This is the term employed when the cause of the swelling is unknown. Some of the possible stimulants are stress, infections, caffeine or spicy foods.
The swelling may also be related to an autoimmune disorder, such as Hodgkin’s disease, lupus and leukemia. This usually happens when the immune system produces antibodies that fight C1-INH proteins.
Symptoms of Angioedema
Angioedema welts are not itchy like hives. However, they sometimes occur together. In hives, swelling occurs on the superficial layer of the skin; but in the case of angioedema, the inflammation is within the deeper layers of the skin and is much thicker and pronounced. The condition is quite obvious on the face, lips, eyelids, palms, soles, throat, tongue and even the genitals. The affected areas not only appear swollen and red but can be painful and hot. All of these spontaneously develop within minutes to hours following exposure to the allergen or stimulant and affect one or both sides of the body.
The swelling can be very severe in some individuals, affecting the mucous membranes and submucosal tissues of the throat, stomach, bowels and bladder. In such case, the individual experiences additional symptoms, such as:
- Muscle pain
- Stomach pain and cramps
- Decreased urination
- Tightness of the chest
- Breathing difficulties
It is very important to know how to recognize the symptoms of angioedema that requires an immediate trip to the hospital. This is because the swelling could be a warning of a more severe allergic reaction called anaphylaxis. Some of the signs and symptoms to watch out for include:
- Breathing difficulties
- Increased heart rate
- Bluish skin discoloration
- Mental confusion
Most cases of angioedema are mild and resolve after 3 to 4 days even without treatment. Those affected may find the following helpful to speed up recovery:
- Cool compress and showers
- Wearing loose-fitting clothes
- Avoiding strenuous activities
- Taking over-the-counter antihistamines
Should the condition not improve, professional medical advice must be sought. The doctor will check the swelling and conduct a physical exam to determine if abnormal sounds are produced when breathing. He or she may also request for allergy testing. Those with moderate form of angioedema are usually prescribed antihistamines, corticosteroids, Ranitidine and inhaler medicines. Since breathing is seriously affected for people with severe angioedema, the treatment is primarily focused on opening the airway to facilitate breathing, coupled with the use of antihistamines, steroids, H1 and H2 blockers and epinephrine.
It is possible for another angioedema episode to occur in the future. Still, the odds can be reduced by avoiding anything, be it foods, medicines, herbs and environmental allergens that could trigger its recurrence. Those who have been previously treated for severe angioedema might benefit from carrying epinephrine shots with them always.