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Patient education: Angioedema (The Basics)

Written by the doctors and editors at UpToDate

What is angioedema?

Angioedema is a condition that causes puffiness in the tissue under the skin. People with
angioedema might have swelling of the face, eyelids, ears, mouth, tongue, hands, feet, or genitals
(picture 1).

Some people who get angioedema also get hives. Hives are red, raised patches of skin that are very
itchy (picture 2).

Sometimes, people have symptoms of angioedema when they are having a dangerous allergic
reaction. Call for an ambulance (in the US and Canada, dial 9-1-1) if you suddenly have puffiness
or hives plus any of the following:

● Trouble breathing
● Tightness in your throat
● Trouble swallowing your saliva
● Nausea and vomiting
● Cramps or stomach pain
● Passing out

Why did I get angioedema?

A common cause of angioedema is allergies. If you just got angioedema for the first time, it might be
because you have a new allergy to something. Allergies to the following things can cause
angioedema:

● Medicines (described below)

● Insect stings
● Foods, such as eggs, nuts, fish, or shellfish
 ● Something you have touched, such as a plant, animal saliva, or latex
● Exercise

The medicines that can cause angioedema include:

● Antibiotics (usually with hives, trouble breathing, and other symptoms of an allergic reaction)

● Medicines used to treat high blood pressure or heart disease called angiotensin-converting
enzyme inhibitors (or "ACE inhibitors") – Examples include enalapril, captopril, and lisinopril.
People who get angioedema because of these medicines usually don't have hives or itching.

● Over-the-counter medicines for pain and fever, such as aspirin, ibuprofen (sample brand names:
Motrin, Advil), and naproxen (sample brand name: Aleve)

Angioedema can also be caused by rare diseases that sometimes run in families. An example is
hereditary angioedema. In this disease, people get repeated attacks of angioedema, belly pain, or
swelling in the throat. These attacks last 2 to 5 days and then get better. However, the disease is
serious because swelling in the throat can cut off the air supply. If you have angioedema and other
people in your family do too, you should see a doctor. There is testing and treatment for hereditary
angioedema.

Sometimes, doctors don't know the cause of angioedema.

Is there a test for angioedema?

There is no test for most types of angioedema. But your doctor or nurse should be able to tell if you
have angioedema by learning about your symptoms and doing an exam.

How is angioedema treated?

The treatment depends on how serious your symptoms are. If you get angioedema because of a
dangerous allergic reaction, you will need to be treated in a hospital right away. At the hospital, the
staff will give you treatments to stop the allergic reaction and help your symptoms.

If your symptoms are mild, you might not need treatment. But you should try to figure out if anything
triggered your symptoms. If so, you will need to avoid that trigger.

Your doctor might recommend that you take medicines called antihistamines. These are the same
medicines people take for seasonal allergies.
Your doctor might also prescribe medicines called steroids. Steroids can help with itching and reduce
swelling. But you should not take steroids for any longer than you need them, because they can
cause serious side effects. These are not the same as the steroids some athletes take illegally.

If you got angioedema because of a medicine you took, your doctor will switch you to a different
medicine.

Can angioedema be prevented?

You can lower your chances of getting angioedema by avoiding foods, medicines, or insects that
make you have an allergic reaction. If you get angioedema a lot, your doctor might recommend that
you take antihistamines every day.

More on this topic

Patient education: Hives (The Basics)

Patient education: Anaphylaxis (The Basics)
Patient education: What you should know about antibiotics (The Basics)
Patient education: Food allergy (The Basics)
Patient education: Peanut allergy (The Basics)
Patient education: Insect bites and stings (The Basics)
Patient education: Angioedema caused by ACE inhibitor medicines (The Basics)

All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Feb 11, 2020.

The content on the UpToDate website is not intended nor recommended as a substitute for medical
advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified
health care professional regarding any medical questions or conditions. The use of UpToDate
content is governed by the UpToDate Terms of Use. ©2020 UpToDate, Inc. All rights reserved.

Topic 17000 Version 8.0

GRAPHICS

Angioedema of the lips and tongue

Angioedema causes swelling or puffiness, often in the face. These photos show angioedema of the lips
(A) and one side of the tongue (B).

Reproduced with permission from: www.visualdx.com. Copyright VisualDx. All rights reserved.

Graphic 73131 Version 7.0

Hives

Hives are raised, red patches of skin that are usually very itchy. They usually
come and go within a few hours, but they can show up again and again in some
people.

Courtesy of Andrew Samel, MD.

Graphic 79242 Version 6.0