Angioedema


Angioedema

Description, Causes and Risk Factors:

Alternative Name: Quincke's edema.

Angioedema is the rapid edema (swelling) of the deep layers of skin - the dermis, subcutaneous tissue, mucosa and submucosal tissues. Although similar to urticaria (hives), urticaria only occurs in the upper dermis, whereas angioedema affects the tissues beneath the skin. Usually, the swelling lasts a few hours and does not threaten the life of the patient. However, if the swelling progresses rapidly, it can block the upper airway and result in suffocation, in which case the patient should seek medical attention immediately.

Types may include:

    Allergic angioedema.

  • Drug-induced angioedema.

  • Hereditary angioedema.

  • Idiopathic angioedema.

Angioedema can be caused by either mast cell degranulation or activation of the kallikrein-kinin cascade. One of the main causes of this disease is food or medicine allergy. Food stuffs like nuts, eggs, seafood, milk, berries, some medicines (antibiotics, blood pressure), etc can give rise to angioedema in an individual. Sometimes, angioedema can also arise due to sunlight, cold, heat or water exposure. An individual can have this skin allergy due to certain insect bites too. It has also been reported that angioedema can appear along with some autoimmune diseases such as leukemia, Hodgkin's disease, and connective tissue disorders (such as lupus).

Bradykinin is the mediator of this disease in hereditary angioedema types I and II and the newly described type III disorder some of which are caused by a mutation involving factor XII.

Angioedema

Idiopathic angioedema (pathogenesis unknown) may be histaminergic that is caused by mast cell degranulation with histamine release. A minority may be associated with the same autoantibodies associated with chronic urticaria.

Risk factors may include:

    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.

  • Pollen.

Symptoms:

General symptoms include:

    Sudden appearance of red welts, especially near the eyes and lips, but also on the hands, feet, and the inside of the throat

  • Swelling of the skin.

  • Swollen eyes and mouth.

  • Pain or warmth in the affected areas.

  • Difficulty breathing or swallowing, in severe cases.

Other symptoms may include:

    Abdominal cramping.

In some cases (angioedema-eosinophilia) fever, muscle pain, decreased urine, weight gain, and high white blood cell count occur also occur.

Diagnosis:

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. It is important to tell your doctor about all medications you take, including over-the-counter (nonprescription) drugs and supplements, even if you do not take them every day. To help pinpoint the cause of your symptoms, your doctor may recommend that you keep a detailed diary of exposure to possible irritants.

If the cause of your angioedema is not apparent then doctor may perform tests to rule out other underlying cause. They may include:

    Puncture, prick or scratch (percutaneous) test: Tiny drops of purified allergen extracts are pricked or scratched into your skin's surface. This test is usually performed to identify allergies to pollen, animal dander, foods, insect venom and penicillin.

  • Intradermal (intracutaneous) test: Purified allergen extracts are injected into the skin of your arm. Doctors may perform this test if they strongly suspect you are allergic to an irritant even though your puncture test is negative — especially to an irritant to which a future reaction could be life-threatening, such as insect venom or penicillin.

Treatment:

If your symptoms are mild, you may not need treatment. Many cases of angioedema clear up on their own otherwise, the standard treatment for this disease is antihistamines, medications that reduce itching, swelling and other symptoms of histamine release.

Medications used to treat this disease may include:

    Antihistamines.

  • Anti-inflammatory medicines (corticosteroids).

  • Epinephrine.

  • Ranitidine (Zantac).

  • Terbutaline (a bronchodilator).

Note: Medication side effects may present.

Cool compresses or soaks can provide pain relief.

For severe angioedema, doctors may also sometimes prescribe an oral corticosteroid, which can help lessen swelling, redness and itching.

Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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