Angioedema

Causes of Angioedema

There are two main types of angioedema, hereditary and acquired. Hereditary angioedema (HAE) is a rare genetic condition that affects about 1 in 50,000 people worldwide. It occurs due to a deficiency in a protein called C1 inhibitor, which regulates the complement system, a part of the immune system that helps to fight infections. The lack of C1 inhibitor causes an overproduction of bradykinin, a potent vasodilator that increases blood flow and fluid leakage. The excess fluid accumulates in the tissues and causes the sudden onset of edema.

Acquired angioedema (AAE) is a more common form of angioedema that occurs in people without a genetic predisposition. AAE can be caused by various factors, including allergic reactions, medications, infections, and autoimmune diseases. Some common triggers of AAE are:

– Food allergies (such as nuts, fish, shellfish, wheat, and dairy products)
– Insect bites or stings (such as bees, wasps, ants, and mosquitoes)
– Medications (such as ACE inhibitors, NSAIDs, and antibiotics)
– Hormonal changes (such as during menstruation or pregnancy)
– Blood transfusions or immune system disorders (such as lupus, rheumatoid arthritis, and thyroid disease)

Symptoms of Angioedema

The symptoms of angioedema can vary depending on the severity and location of the swelling. In some cases, angioedema can be life-threatening, especially when it involves the throat or tongue, which can cause difficulty breathing or anaphylaxis. The most common symptoms of angioedema are:

– Swelling of the face, lips, tongue, throat, or limbs
– Redness or rash on the skin
– Itching or tingling sensation
– Pain or discomfort
– Difficulty breathing or swallowing
– Hoarseness or voice changes

Diagnosis of Angioedema

The diagnosis of angioedema is based on a thorough medical history, physical exam, and laboratory tests. The doctor may ask about any recent allergies, medications, or illnesses, and perform a detailed examination of the affected areas. Laboratory tests, such as blood tests, skin prick tests, or allergy testing, may be ordered to determine the underlying cause of the angioedema. In some cases, a referral to an allergist or immunologist may be necessary for further evaluation.

Treatment of Angioedema

The treatment of angioedema depends on the cause and severity of the swelling. In cases of mild to moderate angioedema, over-the-counter antihistamines, such as diphenhydramine or loratadine, may be effective in reducing swelling and itching. For severe angioedema, medical treatment is necessary, including:

– Epinephrine injection: in cases of anaphylaxis or life-threatening angioedema, epinephrine may be administered to open the airways and reduce swelling.
– Corticosteroids: oral or injectable corticosteroids may be given to reduce inflammation and swelling.
– HAE-specific medications: in cases of hereditary angioedema, medications that replace or increase the amount of C1 inhibitor protein, such as Berinert or Cinryze, may be necessary.
– Avoidance of triggers: in cases of acquired angioedema, avoidance of triggers, such as certain foods or medications, is essential to prevent recurrent swelling.

Conclusion

Angioedema is a medical condition characterized by sudden swelling of tissues beneath the skin or mucosa. It can either be hereditary or acquired and may affect any part of the body. The symptoms of angioedema vary depending on the location and severity of the swelling and may be life-threatening in some cases. The diagnosis of angioedema involves a thorough medical history, physical exam, and laboratory tests. The treatment of angioedema depends on the cause and severity of the swelling and may include over-the-counter antihistamines, corticosteroids, HAE-specific medications, or avoidance of triggers. If you suspect you have angioedema, consult your healthcare provider for proper evaluation and treatment.