Angioedema
Definition
Angioedema is a swelling, similar to hives, but the swelling is beneath the skin rather than on the surface. Hives are often called welts. They are a surface swelling. It is also possible to have angioedema without hives.
See also: Hereditary angioedema
Alternative Names
Angioneurotic edema; Welts
Causes, incidence, and risk factors
Angioedema may be caused by an allergic reaction. During the reaction, histamine and other chemicals are released into the bloodstream. The body releases histamine when the immune system detects a foreign substance called an allergen.
In many cases, the cause of angioedema is never found.
The following may cause angioedema:
- Animal dander (scales of shed skin)
- Exposure to water, sunlight, cold or heat
- Foods (such as berries, shellfish, fish, nuts, eggs, milk, and others)
- Insect bites
- Medications (drug allergy), such as antibiotics (penicillin and sulfa drugs), nonsteroidal anti-inflammatory drugs (NSAIDs), and blood pressure medicines (ACE inhibitors)
- Pollen
Hives and angioedema may also occur after infections or with other illnesses (including autoimmune disorders such as lupus, and leukemia and lymphoma).
A form of angioedema runs in families and has different triggers, complications, and treatments. This is called hereditary angioedema, and it is not discussed in this article.
References
Dreskin SC. Urticaria and angioedema. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 273.
Temiño VM, Peebles RS Jr. The spectrum and treatment of angioedema. Am J Med. 2008;121:282-286.
Wasserman SI. Approach to the person with allergic or immunologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 270.
Review Date: 5/16/2010
Reviewed By: David C. Dugdale, III., MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Angioneurotic edema; Welts
Symptoms
The main symptom is sudden swelling below the skin surface. You may also develop welts or swelling on the surface of your skin.
The swelling usually occurs around the eyes and lips. It may also be found on the hands, feet, and throat. The swelling may form a line or be more spread out.
The welts are painful and may be itchy. They turn pale and swell if irritated. The deeper swelling of angioedema may also be painful.
Other symptoms may include:
Signs and tests
The doctor will look at your skin and ask you if you have been exposed to any irritating substances. A physical exam might reveal abnormal sounds (stridor) when you breathe in if the throat is affected.
Rarely, the health care provider may perform blood tests or allergy testing.
References
Dreskin SC. Urticaria and angioedema. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 273.
Temiño VM, Peebles RS Jr. The spectrum and treatment of angioedema. Am J Med. 2008;121:282-286.
Wasserman SI. Approach to the person with allergic or immunologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 270.
Review Date: 5/16/2010
Reviewed By: David C. Dugdale, III., MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Angioneurotic edema; Welts
Treatment
Mild symptoms may not need treatment. Moderate to severe symptoms may need treatment. Breathing difficulty is an emergency condition.
Cool compresses or soaks can provide pain relief.
Medications used to treat angioedema include:
If the person has trouble breathing, seek immediate medical help.
See: Breathing difficulties - first aid
At the hospital, a tube may be placed in the throat to keep the airway open.
Expectations (prognosis)
Angioedema that does not affect the breathing may be uncomfortable, but is usually harmless and goes away in a few days.
Complications
Calling your health care provider
Call your health care provider if:
Go to the emergency room or call the local emergency number (such as 911) if you have:
Abnormal breathing sounds (stridor)
Difficulty breathing
Wheezing
References
Dreskin SC. Urticaria and angioedema. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 273.
Temiño VM, Peebles RS Jr. The spectrum and treatment of angioedema. Am J Med. 2008;121:282-286.
Wasserman SI. Approach to the person with allergic or immunologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 270.
Review Date: 5/16/2010
Reviewed By: David C. Dugdale, III., MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Angioneurotic edema; Welts
Prevention
To prevent angioedema from coming back:
Never take medications that are not prescribed for you.
References
Dreskin SC. Urticaria and angioedema. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 273.
Temiño VM, Peebles RS Jr. The spectrum and treatment of angioedema. Am J Med. 2008;121:282-286.
Wasserman SI. Approach to the person with allergic or immunologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 270.
Review Date: 5/16/2010
Reviewed By: David C. Dugdale, III., MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 5/16/2010
Reviewed By: David C. Dugdale, III., MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.