Angioedema is a medical condition characterized by swelling of the deeper skin layers caused by fluid build-up. This swelling can affect any body part, but it is most commonly seen around the eyes, lips, genitals, hands, and feet. Many people with angioedema also experience urticaria (hives), which present as a raised, red and itchy rash. The physicians at Penn Medicine Becker ENT & Allergy can help patients manage angioedema.
- What is Angioedema and What Causes it?
- Angioedema Treatment Medications
- Choosing the Right Doctor for Angioedema Care
- Diagnostic Tests to Check for Angioedema Symptoms
- Benefits of Allergy Immunotherapy
- Angioedema Treatment with a Diet and Exercise Plan
- Understanding Prognosis and Treatment Options
- Lifestyle Changes to Prevent Future Angioedema Attacks
- Caring for Yourself After Angioedema Treatment
- Frequently Asked Questions about Angioedema Treatment
What is Angioedema and What Causes it?
There are four angioedema types: allergic, idiopathic, drug-induced, and hereditary. The causes of angioedema vary depending on the type. Allergic angioedema is triggered by an allergic reaction to substances such as food, medications, or insect bites. Idiopathic angioedema results from an unknown cause, while drug-induced angioedema is caused by a reaction to certain medications. Hereditary angioedema is a genetic condition caused by mutations in specific genes.
The swelling usually appears suddenly and lasts for 1 to 3 days. Patients may feel a prickling sensation before the swelling becomes visible. Other symptoms associated with angioedema include a hot or painful sensation in swollen areas, difficulty breathing, and vision problems.
Angioedema Treatment Medications
Treatment for angioedema depends on the type and severity of the condition. The following medications are commonly used to manage angioedema symptoms:
Histamine H1 Antagonist Medications
These medications, also known as antihistamines, are used to treat allergic and idiopathic angioedema by blocking the effects of histamine, a chemical released during an allergic reaction that causes inflammation and swelling. Antihistamines are often the first line of treatment for allergic angioedema.
Glucocorticosteroids, or corticosteroids, are anti-inflammatory medications that can help reduce swelling and inflammation in cases of allergic and idiopathic angioedema. These medications work by binding to specific receptors in cells that are signaling molecules to contribute to inflammation and swelling. By reducing the production of these molecules, corticosteroids can effectively reduce the inflammation and swelling associated with angioedema.
Kinetin is a plant hormone that has been shown to have the potential for treating hereditary angioedema by increasing the production of the C1-inhibitor protein.
Biologic medications, such as monoclonal antibodies, can be used to treat certain types of angioedema by targeting specific proteins or cells involved in the inflammatory response.
Androgenic steroids are synthetic derivatives of the male hormone testosterone and can be used to treat hereditary angioedema. These medications (such as danazol) will increase the production of a protein called C1-inhibitor, which helps control inflammation and swelling.
Angiotensin-converting enzyme (ACE) inhibitors are medications used to treat high blood pressure, but they can also cause drug-induced angioedema. In such cases (ACEi-induced angioedema), alternative medications may be prescribed to manage the condition.
If there is a deficiency or dysfunction of the C1-inhibitor, it can lead to excessive release of inflammatory mediators. C1-Inhibitor Concentrates are used to treat hereditary angioedema by replacing the missing or dysfunctional C1-inhibitor protein in the body.
Xolair (omalizumab) is an anti-IgE medication used to treat chronic idiopathic angioedema and allergic angioedema that is not responsive to other treatments.
Omalizumab is a monoclonal antibody medication that can be used to treat chronic idiopathic angioedema by blocking the action of immunoglobulin E (IgE), a protein involved in allergic reactions.
Danazol is an androgenic steroid medication used to treat hereditary angioedema by increasing the production of C1-inhibitor protein. In individuals with hereditary angioedema, there is a deficiency or dysfunction in the C1 inhibitor protein, which leads to recurrent attacks of angioedema.
Biologics or Anti-IgE Immunotherapy
Biologic medications or immunotherapy target specific proteins or cells involved in the inflammatory response and can help manage angioedema symptoms. Biologic medications may offer advantages over other therapies for angioedema, such as corticosteroids or antihistamines, due to their specificity and targeted ability.
Choosing the Right Doctor for Angioedema Care
Selecting the right healthcare professional to manage your angioedema is central to receiving the appropriate care and treatment. It is important to find a doctor who specializes in allergy and immunology, is experienced in diagnosing and treating angioedema, and can provide personalized care based on your specific needs and medical history.
Diagnostic Tests to Check for Angioedema Symptoms
The vast majority of angioedema cases can be diagnosed based solely on the history and physical examination, examining the affected skin, discussing symptoms with the patient, and possibly conducting blood or allergy tests. The blood tests for hereditary angioedema are different than the tests for the non-hereditary type and can include genetic testing.
By accurately identifying the type of angioedema and its underlying cause, healthcare professionals can develop an appropriate treatment plan to manage the condition effectively.
Benefits of Allergy Immunotherapy
Allergy immunotherapy, also known as allergy shots or desensitization, can be beneficial for some patients with angioedema, particularly those with allergic angioedema. This treatment involves administering gradually increasing doses of the allergen to help the immune system become less sensitive to it. Over time, this can reduce the severity of allergic reactions and angioedema symptoms, improving the patient’s quality of life.
Angioedema Treatment with a Diet and Exercise Plan
When it comes to managing angioedema, it is essential to be mindful of the foods you eat. While it is crucial to consume nutrient-dense and wholesome options, it is equally important to steer clear of certain foods that could exacerbate the condition. These foods to avoid with angioedema include highly allergenic foods like shellfish, nuts, and dairy products. In addition, it is best to avoid store-bought products that often contain flavor enhancers, additives, preservatives, and food coloring. By taking a proactive approach to your diet, you can help minimize the likelihood of angioedema symptoms and boost your overall health and wellbeing.
Moderate exercise can have an anti-inflammatory effect and may potentially reduce the frequency and severity of angioedema attacks in some individuals. However, depending on the underlying cause of the angioedema, certain types of exercise or physical activity may need to be avoided or modified to reduce the risk of triggering an attack.
Understanding Prognosis and Treatment Options
The prognosis for angioedema depends on the type, severity, and underlying cause of the condition. Angioedema cannot be cured but can be effectively managed with medications and lifestyle changes. It is essential to work closely with your healthcare provider to develop a personalized treatment plan that addresses your specific needs and medical history.
Lifestyle Changes to Prevent Future Angioedema Attacks
Preventing future angioedema attacks involves identifying and avoiding triggers, as well as making certain lifestyle changes. These may include:
- Avoiding known allergens or irritants
- Managing stress through relaxation techniques, such as meditation or yoga
- Prioritize sleep and self-care
- Quitting smoking and limiting alcohol consumption
- Following your healthcare provider’s recommendations for preventive medications and other treatments
Caring for Yourself After Angioedema Treatment
After receiving angioedema treatment, it is essential to take care of yourself and follow your healthcare provider’s instructions. Here are some self-care suggestions:
- Take the prescribed medications as directed
- Monitor your symptoms and contact your healthcare provider if they worsen or do not improve
- Avoiding triggers that may have caused the angioedema attack
- Get enough sleep, try a cooling bath, and wear loose clothing
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