Angioedema

January 26, 2018

 

Angioedema causes alarm to patients and is a frequent cause of Emergency Department admissions.

It's  sudden and shocking change to your physical appearance,  especially with lip, tongue or eye swelling can often be quite extreme.

 

Yet angioedema is not usually dangerous, and in general, most mild to moderate symptoms can be sufficiently treated with anti-inflammatory medication

 

Angioedema occurs when small blood vessels leak fluid into the deep dermal, subcutaneous and/or submucosal tissue, causing swelling. Typically the swelling usually occurs around the face, lips and tongue but can also affect the throat, hands, feet and genital area. 

 

Angioedema can occur with or without the presence of hives (itchy weal-like swellings on the surface of the skin). Usually if the cause is allergy related, angioedema and hives will occur simultaneously.

 

Interestingly, allergy is a very rare cause of angioedema especially when it occurs in the absence of hives.

 

More commonly, angioedema can be related to a side effect of blood pressure medications such as  ACE (angiotensin converting enzyme) inhibitors, however can also be triggered by food or drug allergies, infection or illness, autoimmune disorders, and hereditary factors.

 

A rare heritable form of angioedema is called Hereditary Angioedema (HAE) which is due to a problem with the C1 esterase inhibitor.

 

Contact allergies, animal allergies and insect stings can sometimes cause swelling which resembles angioedema.

 

An episode of angioedema typically lasts between one and three days but can sometimes persist for weeks.

 

Allergy-induced angioedema may be suspected if the swelling is rapid in onset but resolves within 24 hours. Swelling which persists for days or weeks is rarely caused by allergy.

 

Exposure to temperature extremes, hormonal changes, emotional stress, medications (such as aspirin) and dietary factors can exacerbate angioedema.

 

Severe swelling of the throat or tongue is a medical emergency owing to the risk for breathing difficulties and airway obstruction. Individuals should seek immediate medical attention.

 

Reference List:
Australasian Society of Clinical Immunology and Asthma [ASCIA]. 2010. Angioedema. ASCIA Education Resources (AED) Patient Information. Accessed 31 July, 2015, http://www.allergy.org.au/images/stories/aer/infobulletins/2010pdf/AER_Angioedema.pdf

 

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