Angioedema, also known as angioneurotic edema, describes a spontaneous swelling deep below the skin surface. Angioedema is similar to hives but the swelling is much greater, the skin is less red, and there is much less itching. Angioedema swellings frequently occur on the lips and around the eyes. Swellings may also occur on the hands, feet, genitals, throat and tongue. Angioedema is generally not a danger unless in the rare circumstance that swelling of the throat or tongue obstructs breathing.
Angioedema may occur as a result of an allergic reaction but often occurs spontaneously, independent of an allergic trigger. This is called idiopathic angioedema. Allergic triggers are usually obvious. One cause of angioedema that is frequently overlooked is ongoing treatment with an “ace-inhibitor” medication. Patients who suffer from angioedema should never take first generation ace-ihibitors.
Angioedema often occurs with hives. When angioedema occurs independent of hives, a blood test may be necessary to check for a condition known as hereditary angioedema (HAE). HAE requires special treatment. There are new medications specifically for the treatment of hereditary angioedema. HAE does not necessarily "run in families" as the name implies.
Some cases of Angioedema may responds to treatment with antihistamines. Sometimes oral steroids are required. Rarely, severe episodes of breathing difficulty may require treatment with Epi-Pen and emergency room visit. Angioedema affecting the larynx may cause life threatening airway obstruction.
Authored by Robert Settipane, MD