Angioedema Unveiled: Understanding Causes, Symptoms, and Effective Treatments

Angioedema can be triggered by various factors, and it is broadly categorized into allergic and non-allergic types.

Allergic Angioedemamay manifest by way of allergic reactions. In essence, when the body encounters an allergen—such as certain foods, medications, insect stings, or latex—it releases histamines and other chemicals that cause blood vessels to leak and swell. Common allergens include shellfish, nuts, and penicillin. In very severe allergic reactions, you could face breathing problems or wheezing, racing heart, swollen face, lips, mouth, tongue and throat. Medications such as Austedo, Rexulti, Cibinqo, Xeljanz and Haegarda Vial, for instance, can all cause an allergic side effect like that. In case you find yourself in the midst of a severe reaction like that, it might be best to seek expert medical attention as soon as possible.

Hereditary Angioedema (HAE) is a genetic condition passed down through families. It is caused by a deficiency or dysfunction of a protein called C1 inhibitor, which regulates the immune system's inflammatory response. This dysfunction leads to excessive activation of other proteins involved in inflammation, resulting in recurrent swelling episodes. HAE can be classified into three types: Type I (C1 inhibitor deficiency), Type II (dysfunctional C1 inhibitor), and Type III (normal C1 inhibitor with unknown mechanisms).

Acquired Angioedematypically occurs due to other medical conditions or medications. It may be associated with autoimmune diseases, infections, or certain drugs, particularly ACE inhibitors used for hypertension and heart failure. In some cases, angioedema can result from conditions like liver disease or malignancies. In the case of Idiopathic Angioedema, it is difficult to identify a clear cause. Due to the lack of a cause, it can concurrently be challenging to manage the uncertainty surrounding triggers and treatment options.

The primary symptom of angioedema is swelling, which often appears suddenly and can affect various parts of the body. Common symptoms include:

• Swelling of the face: Including the eyes, lips, and tongue.
• Swelling in the throat: Which may cause difficulty breathing or swallowing.
• Swelling of the limbs: Hands, feet, and arms can become noticeably swollen.
• Abdominal pain: In some cases, swelling in the abdominal area can lead to severe discomfort and pain.

The swelling can range from mild to life-threatening, particularly if it affects the throat or airway, leading to difficulty breathing, which may require immediate medical attention.

Diagnosing angioedema involves a thorough medical history and physical examination. Doctors will inquire about recent exposures to potential allergens, medications, and any family history of similar symptoms. Diagnostic tests may include:

• Blood tests: To check levels of C1 inhibitor and other markers.
• Allergy tests: To identify specific allergens.
• Imaging: In some cases, imaging studies like ultrasound or CT scans may be used to assess the extent of swelling.

The treatment of angioedema depends on its cause:

Allergic Angioedema:

• Avoidance: The primary approach is to avoid known allergens.
• Antihistamines: These medications can help reduce swelling caused by allergic reactions.
• Corticosteroids: In severe cases, corticosteroids may be prescribed to reduce inflammation.

Hereditary Angioedema (HAE):

• C1 Inhibitor Replacement Therapy: This involves replacing or supplementing the deficient or dysfunctional C1 inhibitor.
• Bradykinin Receptor Antagonists: Medications like icatibant can help by blocking the action of bradykinin, a substance involved in angioedema.
• Androgens: In some cases, androgens like danazol may be used to increase C1 inhibitor levels.

Acquired Angioedema:

• Addressing the underlying condition: Treatment focuses on managing the underlying disease or discontinuing the offending medication.
• Medications: Similar to allergic angioedema, antihistamines and corticosteroids may be used to manage symptoms.

Idiopathic Angioedema:

• Symptom management: Treatment often focuses on controlling symptoms with antihistamines and corticosteroids, while ongoing monitoring and evaluation are necessary.

Preventing angioedema largely depends on identifying and avoiding triggers. For individuals with hereditary angioedema, regular use of prescribed medications and adherence to management plans are crucial. For others, being aware of potential allergens and managing conditions like autoimmune diseases can help reduce the risk of episodes.