Angioedema - How To Detect It?

The body’s reacts to anything suspicious by developing an allergic reaction. Some of the common substances inducing this reaction include certain food substances, pollen, insect bites and certain metals. This body recognises these suspicious substances as antigens and produces what is known as antibodies. These produce various allergic reactions in the body ranging from something as minor as a skin rash to something drastically fatal as respiratory distress and even death.

Features:

1. Angioedema is one of the most severe forms of allergic reactions.
2. Translated literally as swelling of the blood vessels, angioedema causes swelling of the blood vessels in the underlying layers and this can lead to the formation of giant hives.
3. The hives or rashes are extremely itchy, reddish, and can vary in shape (oval or circular). The hives also are warm and painful when touched.
4. Angioedema usually affects the skin but can have more severe effects like blocking the airway and leading to respiratory distress

Causes: Angioedema is usually caused by one of the following:

1. Insect bites or stings
2. People with allergies to foods like peanuts, eggs, milk, shellfish, chocolates, tree nuts, etc.
3. Pollen, animal dander, latex, poison ivy, and other common allergens
4. Medicines like penicillin, aspirin, ibuprofen, and some anti-hypertensives
5. Autoimmune skin disorders like lupus
6. Reaction to incompatible blood transfusions
7. Weather conditions like extremes of cold, heat, or pressure
8. Infections like hepatitis, cytomegalovirus infections, Epstein-Barr infections, etc.
9. Conditions like leukaemia and thyroid disorders
10. Extreme emotional stress
11. Genetic angioedema, inherited from parents by children, which can last forever

Risk factors: Though hives usually develop without any warning signs, the following are some risk factors for developing angioedema.

1. Previous history of allergies
2. Predisposition to develop allergic reactions (overactive immune system)
3. Genetic history of allergies, especially of angioedema

Diagnosis:

1. In first-time patients, a detailed history with deep dive into similar instances in the past will be done
2. A physical exam to check for missed hives (like the back) is then done
3. Allergy testing may also be required to test if a person has a high predisposition to allergies
4. Blood testing to check for eosinophils, which is usually high in patients with allergies, is done.
5. Allergy testing to identify the triggering agent may be done if the trigger is not known. This will help in preventing further attacks.
6. If genetic angioedema is suspected, C1 esterase inhibitor test and complement particles are also checked.

Treatment:
Non-medical treatment including loose clothing, cool compresses, and copiously moisturizing to reduce dryness and itching. This is usually sufficient in the majority of the cases.
Medical: Antihistamines like cetirizine and loratadine are the next line of treatment. Very severe cases may require steroids like prednisone.