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Angioedema
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- This is a syndrome of swelling in the deep layers of the skin. Lip swelling is usually prominent. It is often associated with Urticaria (hives).
- Angioedema is often caused by an allergic type reaction (i.e., the body's defense system mistakenly goes off, initiating reactions in the body). This occurs because histamine released from mast cells starts a cascade of events that result in allergy and Angioedema.
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- Lip swelling
- Eyelid swelling
- Tongue swelling
- Hives
- Nausea/vomiting
- Intermittent sharp abdominal pain
- History of sudden onset of shortness
of breath
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- Pollens
- Foods (i.e., shellfish, eggs,
nuts, chocolate, tomatoes, milk, and berries)
- Medications
- Molds
- Bee stings
- Venom
- Dermographism (a form of Urticaria)
- Cold
- Light
- Exercise
- Inherited forms (genetic) hereditary Angioedema or HEA
- Complement mediated (an immune
pathway)
- Medications (nonallergic, but
direct cause, such as ACE inhibitors)
- Aspirin
- Other anti-inflammatories
- Dyes
- Chemicals
- Emotional stress
- Unknown
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- Swelling of lips, eyelid or
tongue -- usually resolves within 72 hours.
- There is very little aching.
- Hives may or may not be present.
- Stridor (wheezing in neck area)
- Laboratory findings may include:
- Abnormal complement levels (i.e.,
C4, C1 assay may help in diagnosing HAE)
- Vasculitis workup may be done (ANA, RA, CBC, ESR) if no other etiology for Angioedema is
found.
- Rarely, skin biopsy is
needed.
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- Antihistamines (e.g., Hydroxyzine
for acute attacks)
- Doxepin (an older antidepressant)
helps with chronic (continuous) form
- Calcium channel
blockers
- Terbutaline
- Colchicine
- Danazol
- Plasmapheresis (exchange of plasma in blood) used for
rare unresponsive chronic
forms
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- Angioedema can be life
threatening. Seek emergency medical
treatment.
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- Identify and eliminate causative
agents. Special diets may be
prescribed.
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- Angioedema often involves complicated immune chemical pathways. Often your primary care physician will need to refer you to allergy specialists in order to properly treat your condition.
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