Angioedema involves swelling of areas of tissue beneath the skin and can even affect the throat and the face. It is important to note that angioedema often manifest together with hives. Both angioedema and hives involve swelling but the difference with angioedema is that it is deeper and might not even itch.
Acute angioedema
The acute form develops abruptly after being exposed to a trigger such as the following:
- Allergy injections
- Certain drugs such as non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, ACE inhibitors and certain opioids
- Insect bites or stings
Oftentimes, the membranes that line the mouth, throat and airways become swollen which makes breathing or swallowing difficult. - Certain foods such as fish, eggs, nuts, shellfish and fruits
Chronic angioedema
The condition can be chronic which recurs over a span of weeks or months. The cause might be habitual, accidental use of a particular substance such as a preservative in food. Using certain drugs such as aspirin or other NSAIDs can also trigger this type of angioedema.
Indications of angioedema
Angioedema can affect a region or the entire hands, eyelids, feet, lips, tongue or genitals. Oftentimes, the membranes that line the mouth, throat and airways become swollen which makes breathing or swallowing difficult. Occasionally, the digestive tract is involved which results to abdominal pain, nausea, vomiting or diarrhea.
Many individuals also have hives which usually start with itchiness. In most cases, the hives usually come and go. A single spot might linger for several hours and then vanish and later on appear elsewhere. Once the hive vanishes, the skin usually appears normal.
Diagnosis
The cause of angioedema is often evident and tests are seldom required since the reactions typically resolve and do not recur. In case angioedema recurs and the precise cause is not clear, the doctor will ask about the drugs taken and any food or beverages consumed.
In case the cause is vague, especially if the individual does not have hives, the doctor might require testing for hereditary or acquired forms of angioedema.
Management of angioedema
If the cause is evident, the individual must avoid it if possible. If the cause is unclear, the individual should stop using all non-essential drugs until the symptoms resolve.
When it comes to mild cases with hives, antihistamines can be used to partially alleviate the itchiness and swelling. The corticosteroids that are taken orally are given for severe symptoms when other treatments were not effective and taken in a short time as possible. If used for more than 3-4 weeks, it can cause serious side effects.
As for angioedema without hives, antihistamines, corticosteroids and even epinephrine could not help. In such instances, the doctor oftentimes provides fresh frozen plasma or certain medications. In addition, purified C1 inhibitor that is derived from human blood can be used.