Angioedema – causes, types, symptoms, treatment, how to avoid

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Angioedema (Quincke’s edema) is a type of allergic reaction similar to urticaria but deeper within. In most cases, it manifests itself as swelling of the subcutaneous tissue. The swelling is usually diffuse without clear boundaries and is most often localized on the face.

Angioedema – characteristics

Angioedema, otherwise known as Quincke’s edema, is an allergic reaction resembling urticaria, but with the difference that it is deeply located – the tissues under the skin swell. The reaction usually affects the face, but can also occur, for example, on the genitals or the feet. The swelling is painful and diffuse with no clear boundaries. Usually lasts a maximum of three days. Angioedema is considered dangerous, as it is located on the larynx or the glottis mucosa, as it can lead to suffocation of the patient. Possible causes of this condition are allergies, taking certain medications and autoimmune diseases.

Frequency of appearance

There is no precise data on the number of people who suffer from any form of angioedema in Poland. According to the information of the Polish Association for Aid for Patients with Angioedema – up to 4 may suffer from congenital form of this disease. people, although congenital edema has so far been diagnosed in 150 people.

The causes and types of angioedema

The most common causes of Quincke’s edema include:

1. allergies (to chemicals, dyes – often found in food products, drugs, etc.); recently, allergies to hymenoptera venom – mainly wasps and bees – have become a serious medical problem;
2. infections
3. non-allergic agents (e.g. certain medications, preservatives contained in food, etc.),
4. insect venom allergy,
5. the presence of intestinal parasites,
6. autoimmune diseases,
7. spontaneous, hereditary predisposition to angioedema.

Taking into account the causes of angioedema, the following types are distinguished:

1. Idiopathic angioedema – the cause of its occurrence is not fully known, but its occurrence is influenced by: iron deficiency, stress, poorly functioning thyroid gland, deficiency of folic acid or vitamin B12, infections. In many patients, angioedema is confused with allergic edema.

2. Allergic angioedema – it is the most common form of the disease, which usually affects all people allergic to certain foods (it affects about 5% of children and 2% of adults). Ingestion of the allergen leads to swelling, followed by respiratory problems and a drop in blood. To prevent this swelling, you should avoid eating certain foods.

3. Hereditary angioedema – it is caused by passing on abnormalities in genes by parents, it is rare. If it occurs – it appears slowly and affects the throat or intestines, which is why the patient complains of abdominal pain. The occurrence of symptoms is influenced by factors such as pregnancy, infection, taking oral contraceptives, and infection or trauma.

4. Angioedema caused by certain medications – the symptoms occurring in its course are an undesirable effect of some preparations, e.g. drugs used in the treatment of hypertension. Swelling may appear soon after starting drug treatment, and symptoms may be observed for up to three months after drug discontinuation.

Stadiopasta for injuries, injuries and edema, which you can buy separately or in the Day and Night Set for Injuries and Injuries (Stadiopasta + Stadiogel), will help you relieve the symptoms of swelling.

Symptoms of angioedema

Angioedema is painful, diffuse – without clear boundaries, and its symptoms are transient. Most often it affects the face (eyelids, lips). However, it can affect any part of the body, as well as the digestive, respiratory and urinary systems. Edema changes may persist for 1-3 days. Usually, the skin covering the swelling is pale, although it may sometimes appear erythematous. Swelling is not accompanied by itching; disappears without leaving a trace. If the condition recurs, it often affects the same area of ​​the body. Therefore, over time, the skin in this area may stretch and lose its elasticity (the so-called secondary flaccid skin).

The other characteristic features of angioedema are:

1. difficulty swallowing
2. joint swelling
3. swelling of the glottis
4. sometimes neurological symptoms, such as seizures, headaches, spots in front of the eyes, or swelling of the brain.

Angioedema affecting the mucous membranes of the glottis or larynx is especially dangerous. If left untreated, it can even lead to death by suffocation. Edema of the gastrointestinal mucosa is less dangerous, which is manifested by severe pain in the abdomen, nausea, vomiting and diarrhea.

In the event of severe and rapidly increasing symptoms, an ambulance should be called immediately. Dangerous symptoms include tightening of the throat and problems with breathing.

How is angioedema diagnosed?

It is important in diagnostics above all medical interview with the patient. It is important for the doctor to determine whether the edema is accompanied by urticaria, what medications did the patient take before the attack, what foods does he eat every day, has there been a situation that could cause angioedema? People who see a doctor should inform him or her of any family history of angioedema as this may be a sign that the disease is inherited. During diagnostics, the reaction to the administered preparations is also important. If the patient does not improve after taking antihistamines, adrenaline or glucocorticosteroids, we may be dealing with edema caused by C1 deficiency. Then, in such people, a blood test is ordered to assess the level of one of the components of the complement system – C4. Its reduction is an indication for the assessment of the level and impact of C1 inhibitor on the body.

Patients with nettle-related angioedema are referred for the same examinations as patients with urticaria. Swollen intestines can confuse the doctor and result in unnecessary abdominal surgery.

Treatment of angioedema

In people with an attack, the most important task is to find out if the airway is affected by the constriction of the larynx. If so – the doctor must perform intubation (insert a tube through the larynx into the trachea allowing for breathing), and if it is impossible – he will perform the so-called cricothyroidism (insertion of a small tube directly through the skin of the neck into the windpipe). Hospitalization for at least 24 hours is required in people diagnosed with swelling of the airways.

Patients with angioedema with urticaria are treated with the same drugs as for urticaria without edema. These are mainly antihistamines, the action of which reduces the amount of blisters and the unpleasant itching of the skin. Oral glucocorticosteroids are also used. In contrast, in patients with proven C1 inhibitor deficiency, treatment depends on the severity of symptoms. In the event of a life-threatening situation – the patient is given the missing inhibitor, which, unfortunately, is not only difficult to access, but also very expensive. New drugs (also expensive), such as icatibant and ecalantide, are currently being investigated.

Male hormones, such as danazol, are often used in therapy because they have the opposite effect to female estrogens and thus reduce angioedema. However, they should not be taken for more than two weeks as side effects may occur, especially in women (e.g. hirsutism, menstrual disorder, weight gain, depression, sadness). The use of androgens by pregnant women is contraindicated during the first 6 months of pregnancy. Another drug that can replace C1 inhibitor deficiency is tranxenamic acid.

Blood plasma may also be used in patients with angioedema attacks.

As an alternative, it is worth reaching for kinesiotaping. To do this, order the Cure Tape Kinesiotaping Starter Kit. We also recommend a set of body warming products available on Medonet Market. In it you will find:

1. Thai oil warming Namman Muay,
2. Thai painkiller Namman Muay,
3. A cooling and warming gel wrap.

Is it possible to recover completely?

Angioedema caused by C1 deficiency persists for the rest of life, while the acquired form disappears after curing the disease it is associated with. The swelling caused by medications usually disappears when the medications are stopped (although symptoms may still persist for several months).

How to avoid angioedema?

The first episode of the disease usually occurs unexpectedly, so it is difficult to avoid it, unless we are aware that there have been such cases in the family. You should then be tested to find out if you have this disease. Women with a known disease should not take estrogen. Before minor procedures such as tooth extraction are performed, the physician should decide to administer androgens as a precaution, unless a C1 inhibitor is available. In the case of major surgery – C1 inhibitor (if not available – then androgens, if not, at least plasma). Sometimes androgens are used prophylactically over an extended period of time.

Prophylactic and auxiliary massages can be used in the treatment of edema, e.g. with the use of the heart-shaped stone for the Tadé Pays du Levant massage.

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