Angioedema is swelling beneath your skin. It can happen at many points on your body, including your:
- Face
- Throat
- Larynx (your voice box)
- Uvula (the little piece of skin that hangs from the back of your throat)
- Arms
- Hands
- Legs or feet
It can also happen around your genitals and in your intestines. It’s common to get hives at the same time.
The swelling feels like large, thick, firm welts and can cause redness, pain, or warmth in the swollen areas. If it’s in your lower intestine, it can bring stomach pain. Angioedema can be dangerous if swelling is in your throat or tongue. That can make it hard to breathe. If this happens, you should get medical help right away.
Types and Causes
There are four types of angioedema, and they all have different causes.
Allergic angioedema: This is the most common kind. Your allergic reaction can be to foods, like:
It could also be to:
- Pollen
- Animal dander
- Latex
- Insect stings
Drug-induced angioedema: Some medicines can trigger angioedema. They include:
- Penicillin
- Aspirin
- Other non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen.
Certain blood pressure medicines called angiotensin-converting enzyme (ACE) inhibitors can also cause flare-ups that can happen quickly. Even if you’ve been taking ACE inhibitors for a long time, sudden reactions can still happen.
Hereditary angioedema (HAE): This is rare. It happens when your body doesn’t make enough of a blood protein called C1 esterase inhibitor. That lets fluid from your blood move into other tissues, which brings swelling.
You’ll usually have your first bout of this before you turn 12 years old. You may pass the condition on to your children.
There’s another very rare type called acquired angioedema that has the same symptoms as HAE. It’s different because it doesn’t happen until you’re older than 40. It usually happens when you have a weakened immune system. Unlike HAE, you can’t pass it on to your children.
Idiopathic angioedema: Idiopathic means there isn’t a known cause for your swelling. Possible culprits can include:
Allergic and drug-induced angioedema usually happen within an hour of exposure to your trigger. Hereditary and acquired types usually happen over many hours, but it can feel much faster if you wake up and suddenly discover swelling.
Who Gets It?
You may have a higher chance of angioedema if:
- You’ve had hives, allergic reactions, or if you’ve had angioedema before.
- You have lupus, lymphoma, thyroid disease, hepatitis, HIV, cytomegalovirus, Epstein-Barr virus, or have had a blood transfusion.
- You have a family history of hives or angioedema.
- You have asthma and take NSAIDs.
- You take ACE inhibitors. This is especially true if you’re a woman or African-American, or if you take angiotensin receptor blockers (ARBs).
- You’ve had recombinant tissue plasminogen activator (rtPA ) therapy for a stroke.
Diagnosis
To find out what type of angioedema you have, your doctor will examine you and talk about your symptoms. They may do blood tests to get more details.
Treatment
Angioedema usually gets better on its own within a few days. If you do need treatment, it can include:
- Medicines to ease swelling and inflammation, like antihistamines and oral corticosteroids
- Drugs to slow down your immune system if antihistamines and corticosteroids don’t work
- Other medicines that ease pain and swelling, like leukotriene antagonists (a group of anti-inflammatory medicines that aren’t steroids)
- Blood protein controllers if you have hereditary angioedema
If your angioedema is drug-induced, your doctor will usually switch you to another medicine that you can handle better.
For a serious attack, you may need a shot of epinephrine (a type of adrenaline). For repeated strong attacks, you may need to carry a pen-like device so you can inject yourself with epinephrine in an emergency.
Prevention
You can avoid allergic episodes if you stay away from foods, medications, or other conditions that trigger angioedema. If you don’t know what’s causing your episodes, try to keep a diary to track foods, symptoms, and situations tied to your symptoms.
Your doctor might suggest you take antihistamines every day instead of just when you need them. This can help get rid of episodes, make them happen less often, or be less dangerous. You also won’t have to wait for the medicine to start working when you need relief.
