Angiooedema, Quincke's Edema, Angioneurotic Edema
Angioedema is a sudden swelling that is mainly present on the face, the airway (tongue, soft palate, throat) or the intestines. The swelling is caused by fluid retention in the skin and underlying tissues. Without treatment, the condition can last for a few days, then it diminishes on its own. It does not itch, but it can be painful.
Angioedema is caused by a defect in the little blood vessels deep in the skin, where there is plenty of space between the subcutaneous connective tissue. The deep blood vessels leak proteins. Those proteins attract moisture and moisture lumps are developed. This is often the result of some sort of allergic reaction to a substance in drugs, foods, candy or drink. If that is the case, angioedema usually occurs only once. It is difficult then to find the exact cause. Angioedema may recur or occur in attacks. In this case, an inherited condition causes the fluid retention. This form of angioedema can already occur at young age. Angioedema is not contagious.
Angioedema occurs mainly in places where the connective tissue is relatively loose, such as eyelids, cheeks, lips, back of the hands, external genitals and foot ridges. Substantial fluid retention may develop there. Angioedema may occur not only in the skin, but also in the mucosa of the mouth, trachea or intestinal tract.
If an allergic reaction is the cause, the first symptoms develop two hours after ingestion of the product. These symptoms last for about twelve hours and then disappear automatically. In case of an underlying disease, the symptoms take longer, ranging from days to months. There are intermediate periods without symptoms. The swellings disappear automatically then.
The consequences of angioedema depend on the place where the swelling occurs. A swollen face doesn’t feel fine and looks very different of course. A swelling in the stomach or the intestinal tract can lead to abdominal pain, but generally without nasty consequences. Angioedema in the trachea can cause serious breathing problems. For most people that’s a frightening experience. The edema can also occur behind the eyeball. That causes an enormous pressure on the eye and the optic nerve.
The doctor can easily make the diagnosis of angioedema on the basis of the visible fluid retention. If the swelling has already disappeared, the condition is more difficult to identify. In that case, angioedema is often confused with allergy. By asking specific questions about the symptoms (including appearance and location of the swelling), the diagnosis can become clear. If necessary, the doctor may perform additional blood tests.
The treatment of angioedema depends on the cause and the place where the swelling occurs.
In case of allergic angioedema, the doctor may prescribe an antihistamine (a drug that suppresses the allergic reaction) or corticosteroids (anti-
When there is swelling in risky places, such as the trachea, an injection of adrenaline is the best treatment. This suppresses the swelling and prevents life-
In the hereditary form of angioedema, the shortage of protein C1 esterase inhibitor should be supplemented. This is done with an injection or an infusion into the vein. Some patients need such an infusion regularly. Also in the hereditary form of angioedema, it is wise for patients to carry an epinephrine injection with them as well.
Angioedema can be very inconvenient, but is usually not serious. A swelling in the throat, however, can be life-