angioedema

What is Angioedema?

Angioedema is a condition characterized by the swelling of the deeper layers of the skin, caused by a build-up of fluid [1]. This swelling can occur at various points on the body, including the face, throat, larynx (voice box), and extremities [2].

Causes and Characteristics

Angioedema is often caused by an allergic reaction, but it may also be triggered by other factors such as medications or food allergies [4]. The condition is characterized by a rapid onset of swelling, which can be localized to specific areas of the body [5]. In some cases, angioedema can occur without any clear cause, known as idiopathic angioedema [7].

Symptoms and Effects

The symptoms of angioedema include swelling, often around the eyes, lips, and extremities. This swelling can be non-pitting, meaning it does not leave an indentation when pressed [6]. In severe cases, angioedema can affect the larynx, which can lead to difficulty breathing or swallowing.

Key Points

• Angioedema is a condition characterized by the swelling of deeper skin layers due to fluid build-up.
• It can occur at various points on the body, including face, throat, and extremities.
• Allergic reactions are a common cause of angioedema, but other factors like medications or food allergies may also trigger it.
• Symptoms include rapid onset of localized swelling, often around eyes, lips, and extremities.

References

[1] Context result 1: Oct 17, 2024 — Angioedema is the swelling of the deeper layers of the skin, caused by a build-up of fluid. [2] Context result 2: Jul 22, 2023 — Angioedema is swelling beneath your skin. It can happen at many points on your body, including your: Face; Throat; Larynx (your voice box) ... [4] Context result 4: Oct 12, 2023 — Angioedema is the rapid edema, or swelling, of the area beneath the skin or mucosa. It is normally caused by an allergic reaction, but it may ... [5] Context result 5: Angioedema is a skin reaction similar to urticaria. It is characterised by an abrupt, temporary, localised swelling of the deep dermal layer, subcutaneous ... [6] Context result 6: by CE Ciaccio · 2011 · Cited by 11 — This syndrome presents with non-pitting, asymmetric swelling of the face, lips, tongue, larynx, genitalia, and extremities, although any part of the body can ... [7] Context result 7: by JA Tarbox · 2018 · Cited by 20 — Idiopathic angioedema means there is no clear cause. Symptoms. Symptoms of angioedema include swelling, often around the eyes, lips, and ...

Common Signs and Symptoms of Angioedema

Angioedema is a medical condition characterized by sudden swelling under the skin, which can be painful and uncomfortable. The symptoms of angioedema can vary from person to person, but here are some common signs and symptoms:

• Swollen skin: Swelling that develops below the skin's surface, which can be red and itchy [3].
• Red welts: Sudden appearance of red welts, especially near the eyes and lips, but also on the hands, feet, and the inside of the throat [6].
• Pain, numbness, tingling, or warmth: Pain, numbness, tingling, or warmth in the affected areas [7].
• Swollen lining of the eyes (chemosis): Swelling of the lining around the eyes [1].
• Breathing difficulty: Difficulty breathing due to swelling in the throat or mouth [1].
• Abdominal cramping: Abdominal cramping and vomiting in some cases [1].

Other Possible Symptoms

In addition to these common symptoms, angioedema can also cause:

• Mild pain and warmth: Mild pain and warmth in the affected areas [2].
• Swelling, especially around the eyes, cheeks or lips: Swelling that is particularly noticeable around the eyes, cheeks, or lips [2].
• Welts that form in minutes to hours: Welts that develop quickly, often within minutes to hours [2].

It's essential to seek medical attention if you experience any of these symptoms, as angioedema can be a sign of an underlying allergic reaction or other serious condition.

References: [1] - Context result 1 [2] - Context result 2 [3] - Context result 3 [6] - Context result 6 [7] - Context result 7

Diagnosing Angioedema: A Comprehensive Overview

Angioedema, a severe and potentially life-threatening condition, requires prompt and accurate diagnosis to ensure timely treatment. The diagnostic process for angioedema involves a combination of clinical evaluation, medical history, and laboratory tests.

Clinical Evaluation A healthcare provider can often diagnose angioedema by examining the affected skin and reviewing your medical history [1]. This initial assessment helps identify the severity and location of the swelling, as well as any potential triggers or underlying conditions.

Laboratory Tests Several blood tests are used to confirm a diagnosis of angioedema:

• C4 level: The most reliable and cost-effective screening test for hereditary angioedema (HAE) is a serum C4 level [5]. A decreased C4 concentration is almost always present during attacks.
• C1-INH protein levels: Specialized blood tests to measure the levels and activity of the C1-INH protein can be performed to help identify HAE types 1 or 2 [4].
• C1 blood test: This test, along with a detailed history of symptoms, is used to confirm a diagnosis of HAE [7].

Additional Tests In some cases, additional tests may be necessary to rule out other conditions that may present similarly to angioedema. These include:

• Skin prick testing or RAST testing: May be used when allergic angioedema is suspected [9].
• Anaphylaxis differential diagnosis: Angioedema can sometimes be confused with anaphylaxis, a severe and potentially life-threatening allergic reaction [9].

Conclusion Diagnosing angioedema requires a comprehensive approach that involves clinical evaluation, medical history, and laboratory tests. By understanding the various diagnostic methods available, individuals can work closely with their healthcare providers to receive an accurate diagnosis and timely treatment.

References:

[1] Apr 17, 2024 — A healthcare provider can often diagnose angioedema by examining the affected skin and reviewing your medical history. [2] by MP Henao · 2016 · Cited by 82 — Once physicians suspect HAE, however, diagnostic methods are reliable and available at most laboratories... [3] To help confirm a differential HAE diagnosis, perform an HAE blood test: measure your patient's serum levels of C4 and antigenic and functional C1-INH levels. [4] Dec 1, 2023 — Specialized blood tests to measure the levels and activity of the C1-INH protein also can be performed to help identify HAE types 1 or 2. [5] Jul 3, 2024 — The most reliable and cost-effective screening test for HAE is a serum C4 level. The C4 concentration is almost always decreased during attacks... [6] What tests will be done to diagnose angioedema? · When the swelling started. · What you may have eaten, taken or touched that could have caused the reaction. [7] To be certain you have HAE, your doctor will evaluate you and ask for a detailed history of your symptoms. They will also perform a C1 blood test. This test... [8] There are three blood tests that are used to confirm HAE - a screening test called C4 and specific tests of the level and function of the C1-inhibitor protein. [9] Skin prick testing or RAST testing may be used when allergic angioedema is suspected. What is the differential diagnosis for angioedema? Anaphylaxis...

Treatment Options for Angioedema

Angioedema can be treated with various medications, depending on its severity and underlying cause. Here are some common treatment options:

• Antihistamines: These medications are often the first line of treatment for mild to moderate cases of angioedema. They work by blocking the action of histamine, a chemical released during an allergic reaction. Examples include cetirizine (Zyrtec) and diphenhydramine (Benadryl). [1][2]
• Epinephrine: In severe cases of angioedema, epinephrine may be administered intramuscularly to help alleviate symptoms. This is often used in emergency situations where the airway is compromised. [6]
• Steroids: Corticosteroids, such as prednisone, can be prescribed to reduce inflammation and swelling associated with angioedema. They are typically used for more severe cases or when antihistamines are not effective. [2][8]
• Tranexamic acid: This medication has been shown to be effective in treating angioedema, particularly in cases caused by hereditary angioedema (HAE). It works by stabilizing blood vessels and reducing inflammation. [7]
• Icatibant: Icatibant is a specific treatment for HAE that can be self-administered during acute attacks. It helps to alleviate symptoms by blocking the action of bradykinin, a chemical involved in the development of angioedema. [1]

Medication Use Statistics

According to recent studies, antihistamines are the most commonly prescribed medication for angioedema, with 61% of patients receiving this treatment. Corticosteroids and other medications, such as tranexamic acid, are also used in various cases. [9]

It's essential to note that each case of angioedema is unique, and treatment may vary depending on individual circumstances. If you suspect you have angioedema or experience symptoms, consult a healthcare professional for proper diagnosis and treatment.

References:

[1] Firazyr Website [2] Jul 1, 2024 - Most cases of angioedema can be managed well with outpatient treatment alone. [3] Jul 1, 2024 - Berinert is indicated for the treatment of acute laryngeal, abdominal, and facial angioedema attacks in children and adults with HAE. [6] by BJ Long · 2019 · Cited by 82 — Histamine-mediated angioedema should be treated with epinephrine intramuscularly, antihistaminergic medications, and steroids. [7] by J Shroba · 2015 · Cited by 19 — The most widely used and successful medication was tranexamic acid (154 patients). [8] Jul 22, 2023 — Medicines to ease swelling and inflammation, like antihistamines and oral corticosteroids [9] Result: | male | female | all antihistamines | 59% | 63% | 61%

Differential Diagnosis of Angioedema

Angioedema is a medical condition characterized by the swelling of the deeper layers of skin and mucous membranes, often accompanied by urticaria (hives). The differential diagnosis for angioedema involves identifying other conditions that may present with similar symptoms. Here are some possible differential diagnoses:

• Anaphylaxis: A severe, life-threatening allergic reaction that can cause swelling, hives, and difficulty breathing [1].
• Hereditary Angioedema (HAE): A rare genetic disorder that causes recurring episodes of angioedema, often without a clear trigger [5].
• Cellulitis: A bacterial skin infection that can cause redness, swelling, and warmth in the affected area [4].
• Allergic Contact Dermatitis: An allergic reaction to certain substances that can cause skin irritation, redness, and swelling [3].
• Drug Hypersensitivity Syndrome: An adverse reaction to certain medications that can cause a range of symptoms, including angioedema [5].

Other possible causes

• Pseudoallergic Angioedema: A condition where the body's immune system reacts to certain substances without an actual allergic response [7].
• Idiopathic Angioedema: A rare condition where the cause of angioedema is unknown [7].
• Bradykinin-induced Angioedema: A type of angioedema caused by the release of bradykinin, a peptide that can cause blood vessels to dilate [7].

References

[1] Context 1: Jul 1, 2024 - Differential Diagnoses · Acute Urticaria · Anaphylaxis · Cellulitis · Delayed Hypersensitivity Reactions · Drug Allergies · Food Allergies. [3] Context 3: by EN Charlesworth · 2002 · Cited by 29 — The review then establishes a differential diagnosis for angioedema, which includes allergic contact dermatitis, connective tissue disease, endocrine ... [4] Context 4: Jul 3, 2024 - Differential Diagnoses · Angioedema · Cholinergic Urticaria · Chronic Urticaria · Contact Urticaria Syndrome · Urticarial Vasculitis. [5] Context 5: What is the differential diagnosis for angioedema? · Anaphylaxis · Hereditary angioedema · Cellulitis · Allergic contact dermatitis · Drug hypersensitivity syndrome ... [7] Context 7: by JA Bernstein · 2017 · Cited by 170 — Bradykinin-induced angioedema is the most common cause of nonhistamine-mediated angioedema. Pseudoallergic angioedema and idiopathic angioedema ...