Angioedema: Causes, Symptoms, and Treatment Options

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Hereditary angioedema affects one in every 50,000 people. It causes sudden and severe swelling under the skin. This swelling is a big concern, especially when it occurs in the throat. The throat swelling can make it hard to breathe, leading to a life-threatening situation.1 Surprisingly, 20% to 25% of people in the U.S. will have angioedema or hives at least once in their life.1

This article dives into what causes angioedema, its symptoms, and the newest treatment choices. It’s meant to help those dealing with this tough illness by giving them important information.

Key Takeaways

  • Angioedema is a serious condition characterized by swelling beneath the skin, often in the face, throat, and other areas of the body.
  • Angioedema can be caused by allergic reactions, medications, hereditary factors, and other triggers.
  • Swelling in the throat or larynx can be life-threatening if it blocks the airway.
  • Different types of angioedema include acute allergic, non-allergic drug-induced, hereditary, and acquired forms.
  • Treatment options range from antihistamines and corticosteroids to immune system suppressants and blood protein controllers.

What is Angioedema?

Definition and Overview

Angioedema makes the deeper layers of your skin swell, affecting your face, lips, and other body parts.2 It’s quite different from hives, which are itchy bumps on the surface of your skin. Both can happen at the same time, but they have separate causes and signs. Angioedema can quickly get serious, especially if your airways swell up.

Difference from Hives or Urticaria

The main difference between angioedema and hives is how deep they affect your skin. Angioedema swells the deep layers under your skin, while hives swell just the top skin layers.2 Angioedema swelling happens fast and can block your airways, which is very dangerous. But, hives don’t usually cause this airway problem. Knowing these differences is key to getting the right diagnosis and treatment.

Types of Angioedema

Angioedema comes in many forms, each with its own causes and traits. It’s key to know the types for the right diagnosis and treatment.

Acute Allergic Angioedema

This type shows up quickly, often after eating certain foods, taking meds, or getting insect bites or stings.1 Symptoms start in minutes to a couple of hours, usually with hives.

Non-Allergic Drug Reaction

Some medications like ACE inhibitors or NSAIDs can trigger angioedema without an allergic response1. It happens due to the drugs’ effects, not the immune system.

Idiopathic Angioedema

When the cause is unknown, it’s called idiopathic angioedema1. Swelling can happen in different body parts, like the face or hands, for no clear reason.

Hereditary Angioedema

HAE is a rare genetic condition linked to a problem with a specific protein1. Swellings come and go, without a set pattern.

Acquired C1 Inhibitor Deficiency

Developing later in life, this type can arise due to health conditions like B-cell lymphoma1. It’s not passed down and might be tied to other illnesses.

Vibratory Angioedema

A rare kind that happens when skin is exposed to vibrations, leading to hives and swelling1. It can last around six weeks.

Knowing about the many types helps doctors find the causes and treat angioedema. This makes it easier to manage the condition.

Angioedema Symptoms

Angioedema causes fast swelling. It often happens in the face, lips, throat, hands, feet, or genital area.1 This swell can also make the area red, warm, and slightly hurt.3

Swelling Locations

The face, lips, throat, hands, feet, and genital area swell with angioedema most often. This swelling happens suddenly and is usually painless.

Accompanying Symptoms

Besides swelling, angioedema might cause redness, warmth, and some pain in those areas. These signs show the body fighting the problem that started the swelling.

Severity and Complications

In worst cases, swelling in the airways can make breathing hard.3 This is a medical emergency. It needs quick care to prevent severe issues.3 Also, angioedema can cause stomach problems if the intestines get swollen.

1 About 20% to 25% of Americans will have angioedema and/or hives at least once.13 Severe angioedema can be life-threatening by blocking the airway.3

Causes of Angioedema

Angioedema happens because of many things. This can include allergies, certain drugs, and things you get from your family or life experiences. Knowing the reasons helps doctors and patients find the best ways to deal with this problem.

Allergic Triggers

Allergic reactions are the top reason for angioedema. They come from eating certain foods like shellfish, or from things like insect bites.2 Even some drugs can start this problem.

Medication-Induced Causes

Some medicines, like those for high blood pressure, can also cause angioedema. This happens even if you’re not allergic to the medicine.2 Symptoms may show up within an hour of taking the drug.

Hereditary and Acquired Factors

Not everyone gets angioedema the same way. Some people inherit it, especially if they have a family history. Others might get it later in life, for reasons like a weak immune system or other health problems.24

Vibratory angioedema is rare and comes from being around repeated vibrations. And then there’s idiopathic angioedema, which just happens without a clear reason. It could be due to stress, infections, extreme temperatures, or excessive exercise.12

Knowing what causes angioedema is key to treating it well. With the right information, doctors can create a treatment that fits the specific cause. This can help stop angioedema from happening again.

Risk Factors for Angioedema

If you or your family has had angioedema before, you might be more likely to get it too.3 Conditions like lupus, lymphoma, issues with your thyroid, or certain viral infections can also up your risk.2 Using ACE inhibitors or NSAIDs, having asthma, raises these odds even more.2

Allergic angioedema is the top kind you might hear about,2 and it’s often seen with some medicines for blood pressure called ACE inhibitors.2 Hereditary angioedema, known as HAE, shows up early in life, before 12.2 But, there is another type, acquired angioedema, that happens more often in older adults, after 40.2

Having a past of hives, allergies, or angioedema increases the chance of getting it again.2 If you also have asthma and use NSAIDs, you’re at more risk. The same is true if you use drugs like ACE inhibitors, ARBs, or have had stroke therapy.2

Surprisingly, your racial background also plays a part in how likely you are to have angioedema.5 Being Black has a big relationship with getting angioedema, especially if you use ACE inhibitors.5 In places like the Bronx, with many Black people, the risk goes even higher due to high hypertension rates.5

It’s rare for ACE inhibitors to cause angioedema, affecting less than 1% of users.5 But among those who do, over half of the deaths in the last 30 years were Black people.5 On the other hand, more than half of HAE cases in the U.S. were in Caucasians.5

So, many things can affect your angioedema risk, from your health history to the medicines you take, and even where you come from. It’s key to understand and manage these risks for dealing with angioedema well.

Diagnosis of Angioedema

Diagnosing angioedema is key to getting the right treatment. Doctors use physical examination and blood tests. They figure out what’s causing the angioedema.

Physical Examination

Doctors check where the swelling is and what it looks like. They also look for other symptoms. The exam focuses on areas like the face or hands to see how bad the swelling is.1 Acute allergic angioedema can start fast, from minutes to two hours after contact with an allergen. It’s often seen with hives.

Blood Tests

After the exam, doctors might order blood tests. These tests help find the type of angioedema and rule out other illnesses. They might measure C1 esterase inhibitor levels. This is a protein that helps prevent too much fluid building up.1 About 1 in 50,000 people have hereditary angioedema (HAE). Depending on what they suspect, doctors might also check on things like clotting or autoantibodies.

Combining the physical examination and blood tests helps in making the correct diagnosis. This is crucial for starting the right treatment to help with the patient’s angioedema.

Treatment Options for Angioedema

Treating angioedema1 depends on its cause and how bad it is. Antihistamines and corticosteroids are the first steps because they lower swelling and stop the body from overreacting.6

Antihistamines and Corticosteroids

For serious or long-lasting cases, doctors may use drugs that calm the immune system. These include leukotriene antagonists and drugs that control blood proteins.6

Immune System Suppressants

Leukotriene antagonists and C1 esterase inhibitors are also good for managing symptoms.6

Leukotriene Antagonists

Blood Protein Controllers

If the swelling is making it hard to breathe, injecting epinephrine is quick and can save a life.6

Epinephrine for Severe Attacks

Allergic angioedema can happen rapidly after contact with an allergen. Quick treatment is key to avoid breathing problems. About 1 in 50,000 people has a kind they’re born with.1

Some forms of angioedema are triggered by activity, like riding a bike or running. This makes it essential to know and avoid what causes your swelling episodes. Around 20% to 25% of Americans will have angioedema at some point, so knowing how to treat it is vital.1

Medications like ACE inhibitors and some painkillers can cause angioedema, too. Doctors must look at a patient’s drug history to manage it best. Hereditary angioedema might pass down if a parent has it or carries the gene.1

Researchers keep studying angioedema to find better treatments. They cover a wide range of topics, from the causes and symptoms to how to treat it effectively.7

They also share findings on how mast cells affect blood vessel leaks and the role of certain antibodies in allergic reactions.7

Furthermore, other studies focus on treating the swelling and pain, offering new insights into managing chronic symptoms like hives and angioedema.

Some look into rare forms to understand their causes and find the best ways to help people who suffer from these conditions. This work is crucial for improving the lives of those affected by angioedema.

Managing Allergic Angioedema

For those with allergic angioedema, knowing what causes their reactions is key. They should keep a detailed diary. This helps them figure out which foods, meds, or things around them trigger angioedema episodes.1 By avoiding these triggers, people can lower how often and how bad their angioedema attacks become.

Identifying and Avoiding Triggers

It’s very important to keep track of angioedema symptoms and what might be causing them. Write down when and where it happens, and what leads up to it. Patterns in these records could show what to stay away from to prevent angioedema.


Preventive Antihistamine Use

Taking antihistamines regularly can also help manage allergic angioedema. These medicines stop the body’s histamine response, which can cause swelling. By blocking this, antihistamines can make angioedema attacks less frequent and less severe.1 Taking them as a preventive step can be a major help. It lets people with known triggers stay in control of their angioedema and enjoy life more.

Hereditary Angioedema Management

Hereditary angioedema (HAE) needs special care because of a gene problem in C1 esterase inhibitor.8 There are two types: Type 1 doesn’t have enough C1 inhibitor. Type 2 has a lot of a bad C1-inhibitor. Both types don’t work well.8 Treatments focus on fixing C1 inhibitor levels. This might be through replacement therapy or using androgens.

It’s key to stop attacks before they start for those with HAE.89 A study found that using subcutaneous C1 inhibitor can help prevent swelling attacks.9 For long-term prevention, options include lanadelumab, different forms of C1-inhibitor, berotralstat, and androgens.8

HAE attacks can happen very often or hardly at all, which makes managing it hard.10 It’s important to tell HAE apart from other kinds of swelling because the treatments are different.8

If you have HAE, your doctors will help you make a plan to avoid attacks and treat them well when they happen. With new medications, life can get better for people with this condition.9

Natural Remedies for Angioedema

Some people try natural remedies along with medical treatments to handle angioedema. This can involve using herbal supplements, essential oils, and changing your diet. They aim to reduce swelling and boost your body’s defenses.11 Always talk to a doctor before using these. They might not mix well with your regular meds, or could cause other problems.

Some supplements like vitamin C and quercetin might ease angioedema symptoms.11 Certain herbs, including goldenseal and chamomile, have been known to help. But, be careful using them if you’re taking other medicines.11 Homeopathic options like Apis mellifica and treatments like acupuncture could also lessen your allergic responses.11

Changing what you eat can also be beneficial. Avoiding foods that you’re allergic to and those high in histamine might cut down on swelling.12 Known food triggers for angioedema are things like seafood, nuts, and chocolate.11

Natural Remedies for Angioedema Potential Benefits
Vitamin C, Vitamin B12, Quercetin, Bromelain May help reduce or prevent angioedema symptoms11
Herbal Supplements (Goldenseal, Licorice Root, Chamomile) Used traditionally to reduce angioedema symptoms, but caution advised due to potential interactions11
Homeopathic Remedies (Apis mellifica) May be used for hives and angioedema11
Acupuncture May help reduce the frequency or severity of allergic reactions like angioedema11
Dietary Adjustments (Eliminating Food Allergens, Reducing High-Histamine Foods) Can help reduce inflammation and the likelihood of angioedema12

Be cautious with natural remedies. While they may aid in angioedema relief, always consult a healthcare provider. The best care includes both natural and standard medical treatments.11,12,13

Homeopathic and Ayurvedic Approaches

Some people use homeopathic or Ayurvedic methods to help with angioedema. Homeopathic doctors give personalized remedies. They look at the person’s symptoms and body type to choose what to use.11

Ayurvedic practices, from India, may change what you eat and how you live to fight angioedema. They suggest using specific herbs to help the body balance and heal itself.11 Before trying these, talking with a healthcare professional is a must.

Homeopathy might suggest Apis mellifica for swelling or Urtica urens for itchy skin. Ayurveda might recommend Guduchi or Amalaki to boost your immunity and fight allergies.11 Both methods focus on solving the underlying issues, not just the symptoms of angioedema.

But, keep in mind, there’s little scientific proof these methods are effective against angioedema. So, it’s smart to discuss these options with a doctor who knows about different types of medicine.11 Working with both conventional and alternative medicine experts can create a better treatment plan for angioedema.

Angioedema in Children

Angioedema is seen in kids, and how we treat it might be different from adults.14 Hereditary angioedema (HAE) can start in childhood, usually before 12 years old.14 It’s key to know what causes it and how to stay away from those triggers.15 Some cases can be very serious, blocking the throat and making it hard to breathe.15 Things like certain foods, bug bites, drugs, and even family history can cause angioedema in children.

Doctors who work with children’s angioedema make specific plans to keep them safe.14 The treatment changes based on what type of angioedema it is. Some cases need medicine every day.14 It can’t be cured, but with the right care, most kids do well.14 They need to visit a doctor who knows about the immune system regularly.14 Some may have to take medicine forever and switch to a doctor for adults when they turn 18.

15 It’s very important to keep up with the care even after the first treatment. This is for the child’s health and safety.15 Medicine might make children sleepy, but it’s still needed for angioedema.15 In severe cases, doctors might tell them to keep a shot of epinephrine with them just in case.

Type of Angioedema Prevalence in Children Key Characteristics
Hereditary Angioedema (HAE) 16 HAE accounts for only 0.4% of angioedema cases. 16 Hereditary angioedema is an autosomal dominant disease usually associated with a positive family history of angioedema. In approximately 80-85% of cases, serum levels of C1 inhibitor (C1INH) are decreased to approximately 30% of reference range values. In contrast, about 15% of patients with hereditary angioedema have reference range levels of antigenic, but mostly nonfunctional, C1INH.
Acquired Angioedema (AAE) 16 AAE1 and AAE2 are very rare in the pediatric population. 16 AAE1 is usually linked to an underlying lymphoproliferative disorder, while AAE2 is associated with autoantibodies that inhibit C1INH function.
Idiopathic Angioedema 16 INAE angioedema may occur in approximately 1 of 20 angioedema cases. 16 Idiopathic angioedema may be associated with swelling or hives that persist longer than 6 weeks.
Allergic Angioedema 16 As many as 50% of children who have urticaria exhibit angioedema, with swelling of the hands and feet. 16 Allergic angioedema is the most common form and is provoked by environmental factors such as food, insect stings, cold, heat, latex, or drugs.
ACE Inhibitor-Induced Angioedema 16 4-8% of angioedema cases are ACE inhibitor-induced angioedema. 16 Swelling caused by ACE inhibitors used in treating high blood pressure may start a few hours to years after starting the medication.

Angioedema and Pregnancy

Angioedema can be challenging during pregnancy. The condition and some treatments may risk the mother and baby. It’s important for pregnant women with angioedema to plan with their doctors. This plan should fit the special needs of pregnancy.

Parents with Hereditary Angioedema (HAE) might pass it down to their babies17. Medicines like danazol, oxandrolone, and stanozolol, used for HAE, are not safe during pregnancy17. HAE attacks are not common when the baby is being born. But, attacks might get worse after birth17. Doctors usually suggest HAE testing for the baby after their first year17.

Taking care of angioedema while pregnant is very important. It helps keep both the mother and baby safe. Treatment might need to change, and close checking is often necessary. Making a plan for dealing with sudden attacks is key. Working with skilled doctors, pregnant women with angioedema can handle these issues well. They can focus on staying healthy and helping their baby.

Living with Angioedema

Living with angioedema can be tough, affecting both the body and the mind.18 Swelling can happen suddenly or over time, and can be caused by different things.18 For example, allergic angioedema and hereditary angioedema react quickly to triggers.18 This swelling usually goes away on its own in a few days.18 Learning to avoid triggers and keeping in touch with your doctor can make a big difference in how you feel.

Coping Strategies

18 Some medications can help with allergic and idiopathic angioedema like antihistamines and steroids.18 For hereditary and allergic angioedema, there are special drugs that boost a key protein to stop attacks.18 In some places, medical cannabis is used to reduce swelling.18 It’s also key to have your medication on hand for emergencies.18 Staying healthy, both physically and mentally, is important too.

Support Resources

Support groups are a great place to find others who understand what you’re going through, whether in-person or online.19 They offer a chance to talk, share tips, and get and give support.

Websites like the HAEA Café or the DiscoverHAE Facebook page are great for support too.19 They connect you to a wider community, helping you feel less alone.


Angioedema is a serious condition that needs careful handling. Knowing the types and recognizing symptoms is crucial. Then, by using the right treatments, people can deal with it better and even avoid severe attacks.20

Support from healthcare experts and finding helpful resources is important for those with angioedema. It can lead to a better lifestyle and health for them.21

Dealing with an angioedema diagnosis may seem overwhelming. However, being well-informed, active, and watchful makes a big difference.2021

Together with doctors, creating a detailed plan for treatment is key. This plan should deal with what causes the issue and how to keep it under control. Also, joining support groups and learning coping skills can make life easier for angioedema patients. It builds their strength and courage.

Overall, this article highlights a complete care and action plan for angioedema.2021 Educating patients and providing the right tools is essential. It helps them manage the disease better and live a higher quality life.


What is angioedema?

Angioedema is a serious condition that causes swelling under the skin. This swelling happens in places like the face and throat. It’s triggered by allergies, some medications, or things passed down in families. The worst part is when the swelling blocks the airway, which can be life-threatening.

How is angioedema different from hives or urticaria?

Angioedema swells the deeper skin layers, making swelling appear suddenly. In contrast, hives make itchy welts on the surface. If the deep swelling blocks the airways, it’s a medical emergency.

What are the different types of angioedema?

There are several types of angioedema. They include allergic, drug reaction, and those with unknown causes. There’s also a hereditary kind, and others linked to certain medical issues. Each type has its own triggers and signs.

What are the symptoms of angioedema?

The main symptom is sudden, deep swelling in different parts of the body. This can be the face, lips, or even the hands. The skin might also get red and feel warm, sometimes with a little pain. When the swelling is at the throat or neck, breathing can get really hard, which means you need medical help right away.

What causes angioedema?

Allergies, some medications, and what runs in the family can start angioedema. Other illnesses impacting your immune system can also be culprits.

Who is at risk of developing angioedema?

People who have had hives or known allergies, or those whose family has, are more likely to get angioedema. The risk increases with conditions like lupus or problems with the thyroid.

How is angioedema diagnosed?

Doctors check you and might do some blood tests. These tests look for things like C1 esterase levels to find out what type of angioedema it is. They also make sure nothing else is causing the problem.

What are the treatment options for angioedema?

Treatments include drugs like antihistamines and steroids to stop the swelling. If it’s severe, you might need epinephrine. In some cases, doctors use medicines that suppress the immune system.

How can allergic angioedema be managed?

Avoiding what you’re allergic to is key. Antihistamines can also help prevent and reduce the swelling. It’s good to work closely with your doctor on this.

How is hereditary angioedema managed?

Hereditary angioedema is managed with special medications, which help keep C1 levels in check. It’s vital to plan to deal with sudden attacks along with working to prevent them.

Can natural remedies or alternative therapies help with angioedema?

Some people try natural or alternative methods, but it’s critical to talk to your doctor first. These methods could affect your regular medications or cause other issues.

How is angioedema managed in children and during pregnancy?

Kids and pregnant women with angioedema need different care. Experts in treating these groups can make plans that help without harm.

What strategies can help with living with angioedema?

Knowing your triggers, staying in touch with your healthcare team, and getting support from others can make living with angioedema easier. Joining support groups can provide a great help and community.

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