Angioedema

Chronic Idiopathic Urticaria Angioedema

What Chronic Idiopathic Urticaria Angioedema really is?

No matter what type they are chronic diseases can be a real pain in the neck. Itchiness and swelling make this pain worse in the case of chronic idiopathic urticaria angioedema. The reason is that it persists for a long time without any known reason.

Urticaria angioedema is characterized by the rapid swelling of the subcutaneous tissue, dermis, mucosa and submucosal tissues and can be throbbing.

If you have been suffering from urticaria angioedema for more than six weeks and there are no obvious causes, you have chronic idiopathic urticaria angioedema. Want to know more about this disease? Read my comprehensive article about chronic idiopathic urticaria angioedema.

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Chronic idiopathic urticaria angioedema is a type of angioedema that occurs in response to unknown causes and persists for more than six weeks. The swelling can be very annoying and may accompany itching and burning, as with other types of chronic urticaria. Many people face problems, as they are unable to open their eyes due to excessive swelling and others may feel difficulty in breathing if the airway is being blocked because of the swelling caused by chronic idiopathic urticaria angioedema.

Urticaria Angioedema

Urticaria angioedema, also known as Quincke’s edema, is the rapid swelling of the subcutaneous tissue, mucosa, and submucosal tissues.

In extreme cases, it may also cause suffocation as the airway can be blocked due to immense swelling. Therefore, if it progresses rapidly, it should be treated as a medical emergency. If urticaria angioedema has occurred in response to an allergy, epinephrine can be extremely useful. However, if the patient has hereditary urticaria angioedema, treatment with epinephrine has not been very helpful.

Autoimmune Urticaria Angioedema

Urticaria angioedema has two major types: hereditary urticaria angioedema and autoimmune urticaria angioedema. The first is a hereditary disease whereas autoimmune urticaria angioedema is caused when certain parts of body fail to recognize its own constituent parts as self, which allows an immune response against its own cells and tissues. There is a certain type of cells called mast cells, which act as a defense system in humans. However, in certain circumstances, these cells become disturbed and release a fluid called histamine. This fluid can damage the surrounding membranes and cause itching and rashes. This process is called autoimmune, and when the result is urticaria, it is called autoimmune urticaria.

Autoimmune Chronic Urticaria Angioedema

Autoimmune urticaria angioedema, when persisting for more than 48 days continuously is a chronic condition called autoimmune chronic urticaria angioedema. The patient may suffer from burning and itchiness.

 

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Vibratory Angioedema – How to Treat Angioedema

Understanding Vibratory Angioedema and Learning How to Treat Angioedema?

Lets talk about Vibratory angioedema.  Well for those who have suffered from this unusual and uncommon skin problem life can be very difficult . All these people want to know is how to treat angioedema.

Characterized by wheals, raised rashes and blanched skin, vibratory angioedema is an uncommon form of physical urticaria (hives). Continuous vibration can causes such rashes to appear on the skin. These vibrations can be from using a jack hammer or even jogging.  This problem can be hereditary as well as acquired.

If you want to learn more about vibratory angioedema or how to treat angioedema, read here for a detailed editorial.

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It might sound strange but it is a fact that vibratory angioedema has nothing to do with angioedema itself, rather it is a form of physical urticaria (or physical hives). How to treat angioedema is the first question that comes into mind of the person experiencing this bizarre skin problem. You will find the answer to this question at the end of this guide in form of simple guidelines for angioedema treatment.

Vibratory angioedema can be an inherited problem or it can be acquired in response to a prolonged exposure to vibration. It is an extremely rare condition in which the skin produces a hypersensitivity reaction to an extended exposure of unremitting vibration. The most obvious symptoms are central wheals, blanched skin, pruritus or raised rashes.

A person prone to vibratory angioedema may develop it from the factors that are normally harmless. These factors cause continuous vibration on the skin e.g. driving a motor bike continuously for a long time, operating such a mechanical instrument e.g. a lawnmower, or vigorously rubbing your skin with rough stimuli e.g. a towel.

The symptoms usually take five to ten minutes to appear after coming in contact with the offending stimuli. The wheals can be itchy in nature and usually fade away within thirty minutes to one hour after their outbreak and no typical treatment is required. To stay safe, the individuals prone to vibratory angioedema should avoid such stimuli.

These simple guidelines are the answer to the question given at the start of this guide i.e. how to treat angioedema.

  • Consult a qualified doctor for proper diagnosis and treatment.
  • Urine and blood test should be conducted to find whether you are infected with angioedema or not.
  • Avoid the allergens and triggering factors.
  • Epinephrine is a life saving drug especially in case of acquired angioedema.
  • Certain therapies of antihistamines are typically used to counter the effect of histamines, especially in cases where autoimmune reaction is the cause of angioedema.

 


Uvula Angioedema

The Most common Forms of Angioedema and Their Home Remedies?

Angioedema is not only extremely painful but it can also be life threatening. Angioedema has some very rare forms e.g. uvula angioedema while there are some common subtypes e.g. facial angioedema. Let us see what home remedies can be helpful when you are battling this deadly disease.

Inthe more common forms of angioedema the swelling usually appears on eyes and lips. This can be a disabling disease. If the swelling is progressing rapidly, try to cool down the place and the patient should stay inside the house.

Taking green tea or mint tea can help reduce the difficulty in breathing by clearing the throat. If the swelling progresses rapidly, especially in the upper airway. make sure the patient is given prompt medical treatment.

The post next week will describe the top four tips when you are trying to manage angioedema.

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Learning about Uvula angioedema?

The mouth is no doubt one of the most sensitive  parts of the human body. Any problem created inside your mouth can stop you from speaking or eating. But uvula angioedema takes this problem to next level because it may even stop you from breathing!

With Uvula angioedema, the swelling occurs on your uvula (petite piece of fleshy tissue hanging down from the back portion of the soft palate in the humans’ mouth),  the last place one would like to swell.

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Angioedema is an annoying, sometimes painful, ugly looking and life-threatening disease. However, uvula angioedema can be the most frightening form. As you know angioedema is the swelling of your eyes, lips hands, feet etc. But in uvula angioedema, the swelling occurs on your uvula, surely the last place one would like to get swelled up.

Angioedema or Quincke edema is the rapid swelling of the human skin resulted by the swelling of dermis, sub-mucosal tissues and mucosa. Usually the swelling lasts a few hours and does not threaten the life of the patient. But in uvula angioedema you need prompt and high-quality medical treatment as it can cause blockage in the airway which can be fatal.

The uvula is the petite piece of fleshy tissues hanging down from the back portion of the soft palate in the humans’ mouth.  It is evident from its appearance that it is very fragile and soft. It is composed of certain glands and muscular fibers. The key function of uvula is articulation of different sounds of speech. If you develop uvula angioedema, it is not your speech or sound that is affected but your life is at stake!

Uvula angioedema is an infrequent subtype of angioedema but it can be fatal. It requires without delay treatment and ongoing cautious monitoring of symptoms as the swelling may block the airway.

Usually, uvula angioedema is acute or hereditary. It can be caused by several diverse factors including inhalation exposure, hereditary angioedema, trauma, in reaction to certain drugs and some contagious causes. The type I hypersensitivity reaction is the typical cause of isolated uvular angioedema.

Usually, uvula angioedema is acute or hereditary. It can be caused by several diverse factors including inhalation exposure, hereditary angioedema, trauma, in reaction to certain drugs and some contagious causes. The type I hypersensitivity reaction is the typical cause of isolated uvular angioedema.

 


Angioedema – Understanding its Causes and Cures

Description

This article discusses  the most common types, causes, signs, symptoms, prevention and the treatment methods of Angioedema.

Angioedema is a allergic reaction that causes swelling on the skin surface. They occurs mostly on the eyes and lips. The body produces something called histamine in result to this reaction and blood vessels begun to swell. It is a deeper swelling and more or less like hives, where you have more itchiness.

There are two types of Angioedema. They are:

Acquired angioedema (AAE)

Hereditary angioedema (HAE)

Causes of Angioedema

The causes are unknown sometimes. But with certain causes, we can suspect that it may be because of these causes:

  • Insect Stings or Pollen
  • Allergies of food like dairy, shellfish, nuts etc,
  • Allergies of  medications such as NSAIDS (non- steroidal anti-inflammatory drugs), aspirin, blood pressure medicines, ibuprofen, and other antibiotics
  • Hair Dyes
  • Diseases like Hodgkins, leukemia, lupus, etc.

 

Angioedema Symptoms and Signs

  • Itchy, Burning, Swollen and Painful feelings
  • Appearance of red welts near lips and eyes and sometimes near throat
  • Rashes on the hands
  • Discolored patches    
  • Swollen throat
  • Hoarseness
  • Breathing trouble
  • Fever
  • Muscle pain
  • Decreased urine, etc.

Treatment Options for Angioedema

Have a allergy test with the professional if you found any of the causes mentioned above.  You should also have to have urine test and blood test in order to find, if you are infected with Angioedema.  If the results show that you have mild angioedema, then it can be cured with certain therapies or antihistamines. If it is major, then you have to make sure that, you can breathe easily. Sit in an open air and try to breathe properly. Have the medicines at the correct time that are prescribed by the professional s properly.  The most important thing is, you should not take any other drugs when you are infected with angioedema.

 


Treating Angioedema

Facts You Must Know About Angioedema?

Today’s post has nothing but some very valuable facts about angioedema, that are not very commonly known. These particulars are not only helpful in avoiding angioedema but also they will be handy for treating angioedema suitably.

Angioedema is different from urticaria or hives. Hives are the red itchy rashes while angioedema is usually a painless swelling deep inside the skin. Angioedema is the most perilous skin problem and it can be deadly. The swelling usually occurs around the eyes or lips known as facial angioedema, but any part of the body can be affected including the hands, arms, tongue, throat or internal organs.

It can be acquired or a hereditary problem, just like hives. Moreover, it can be acute which usually disappears within a few hours after the outbreak or chronic which stays for a longer period. As it can be deadly, consult a doctor as soon as you see the symptoms.

Next post in two days, will be revealing some undisclosed tips for managing angioedema, do not miss it.

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Myths about Angioedema Revealed – A Must-Read for Angioedema Sufferers?

Myths or misconception about a disease can be a great drawback. Not knowing the actual course of action for managing a disease, can mislead you and even backfire. This blog can be a great help for those who are confused while treating angioedema.

Unlike most people think, angioedema is not a subtype of hives (urticaria) and usually it has no association with lupus. As some would say, idiopathic angioedema treatment is not impossible, however it can be difficult.

Angioedema symptoms can be pretty similar to those of acute abdomen so before any surgery make sure a proper diagnosis has been carried out by a qualified doctor. Every swelling does not mean you have angioedema, sorting out the causes or blood and urine tests are helpful in diagnosis.

What facts are important for an angioedema patient to learn? For the answer, read my next post after two days.

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Is Treating Angioedema Possible?

There are many myths about treating angioedema even in this age of modern medical science. The reason is the lack of awareness about this uncommon skin problem. However, learning about angioedema is as important as learning about leukemia or heart disease, because just like them angioedema can also be deadly.

Treating angioedema can be a little tricky but it is not impossible. A proper diagnosis at the early stages can be a great help for the patient. In many cases you can cure your problem by avoiding the causes and triggers.

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Treating angioedema is not as thorny as some people would tell you. The typical treatment is based on the type of angioedema you are suffering from i.e. hereditary angioedema treatment is different from acquired angioedema treatment.

The most difficult of all to handle is idiopathic angioedema, as the causes are unknown. However, you don’t need to lose hope as it is not impossible. You can have an allergy test by a professional doctor. Urine and blood tests can find whether you are infected with angioedema or not. If the results of these tests are positive, certain therapies or antihistamines intake can be opted for treating angioedema.

Acquired angioedema is relatively easier especially if the diagnosis is prompt. Epinephrine has proved to be a life-saving drug in case of acquired angioedema. Furthermore, antifibrinolytics such as tranexamic acid, hereditary angioedema types I and II, and non-histaminergic angioedema may be beneficial. Cinnarizine drug has also been proven to be useful especially in patients with liver problems, as it blocks the formation of C4.

On the other hand, hereditary angioedema treatment is more difficult. In hereditary angioedema, causes and triggers must be avoided as in most of the cases it does not respond to epinephrine, antihistamines, or corticosteroids.

When treating angioedema, the most fine-tuned treatment involves C1-INH concentrate from donor blood, which must be administered under expert authority. In many European countries C1-INH concentrate is not commonly available, therefore, fresh frozen blood plasma, which also contains C1-INH, can also be used as an alternative.

As in case of autoimmune causes angioedema is caused by the histamine release therefore, Histamine H1 antagonists counter the effect of histamine and its response in the sensory nerve endings and the blood vessels. These antihistamines are more effectual in stopping histamine response than in reversing it i.e. they are not much useful if histamine reaction has already taken place.

 


Pressure Angioedema – Thyroid Angioedema

Valuable tips for patients With Pressure Angioedema & Thyroid Angioedema?

People suffering from pressure angioedema or thyroid angioedema know how it can turn their lives into a complete mess. Swelling, itchiness and pain are accompanied by an unwanted appearance which adds to their misery.

Let me define these two terms for:

Pressure angioedema is typically caused by sudden extreme localized pressure applied on to the skin. Certain skin problems that are connected with your thyroid gland and the hormones released by it are pretty similar to angioedema and many people refer to them as thyroid angioedema.

But just knowing the definition may not be enough if you want to get rid of your skin disease. You need to learn more about pressure angioedema & thyroid angioedema.

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This article will give you the details of two uncommon types of angioedema: pressure angioedema and thyroid angioedema. For easier and better understanding I am dividing this article into two virtual parts: the first one explains pressure angioedema and the second one is about thyroid angioedema.

Pressure angioedema is typically caused by sudden extreme localized pressure applied on to the skin. The most obvious symptom is swelling on the affected area but in some cases the effects are deep inside. In some extreme cases the pain persists much longer and may be accompanied by other severe symptoms including low fever, chills, fatigue, joint and muscle aches, and/or headaches. If this is the case with you, you must consult a doctor for a reliableangioedema treatment.

There can be various diverse scenarios where pressure angioedema may occur, but it outbreak commonly after the patient’s skin has been under extreme pressure e.g. it can appear on the individual’s feet after standing on a hard floor or on the buttocks after sitting constantly for an extended period of time.

Certain drugs e.g. Aspirin can also trigger pressure angioedema in the people who are prone to it. The pressure can be from different mechanical tools, tight clothing, carrying heavy items etc. If you are prone to it, you must avoid the factors and activities that can trigger pressure angioedema. You should consult a qualified dermatologist to find out the causes of your specific problem. The patient may consume systemic corticosteroids or non-steroidal anti-inflammatory drugs, however, they produce variable responses in different cases.

Thyroid is the largest gland in human body present in your neck. Certain skin problems that are connected with your thyroid gland and the hormones released by it are pretty similar to angioedema and many people refer to them as thyroid angioedema. Some disorders in the thyroid gland can cause release of hormones from the thyroid which may result in angioedema or hives.

 


Neuro Angioedema – Orolingual Angioedema

Treating Neuro Angioedema & Orolingual Angioedema?

Two more types of angioedema you need to know about are neuro angioedema and orolingual angioedema. Neuro angioedema is pretty rare while orolingual angioedema is  more common and more hazardous as well.

As you can tell from its name, neuro angioedema, certain neurological disorders can result in the development of angioedema. Orolingual angioedema causes the mouth, tongue or lips to swell which looks pretty horrific and also can cause suffocation which may be deadly. Both of them have classified treatment, however a proper diagnosis is mandatory.

If you want to read more about neuro angioedema or orolingual angioedema, read here for a detailed guide.

 

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Neuro angioedema is an extremely rare type of angioedema found in only a few cases whereas orolingual angioedema,  sometimes also referred to as facial angioedema, is relatively more common. For better understanding, this guide is divided into two parts: first one describes neuro angioedema and second one entails orolingual angioedema.

Neurology is a branch of medical science which deals with the nervous system and its disorders. Certain such disorders can cause angioedema which is called neuro angioedema. As it is found very rarely, not much people know about it.

A proper ant timely diagnosis for neuro angioedema is mandatory by having the lesion biopsied and microscopically examined. The treatment varies case to case, however the underlying infection should be treated first with antibiotics. The infection can cause certain other disorders in the mouth, in this case consult an ENT specialist for biopsy.

Orolingual angioedema, as evident from its name, can be characterized by the extreme swelling that occurs in the mouth, on the tongue or lips. In some rare cases uvula can also get swelled up. One of the causes is thrombolysis with alteplase especially in stroke patients. While in some other cases ACE inhibitor therapy can be the culprit. ACE inhibitor therapy increases the chances of orolingual angioedema if the individual is a stroke patient.

The swelling does not only disable the person from speaking but can also cause difficulty in breathing, especially if it progresses rapidly. Such cases should be treated in the ED (emergency department), under the supervision of expert doctors. Swelling can result in upper airway compromise and can be deadly.

The most common treatments involve the intake of dexamethasone and histamine antagonist. Epinephrine is also a great success when treating most types of acquired angioedema .However, as it can be a deadly ailment, consulting a qualified doctor for proper diagnosis and treatment is recommended.

 


Idiopathic Angioedema – Idiopathic Urticaria Angioedema

Little Known Tips for Managing Angioedema Simply?

My regular readers know I always give some interesting tips for helping certain diseases. Today’s post has similar tips about angioedema and idiopathic angioedema. However, never rely merely on this advice because they are not a permanent fix, they are simply to aid your treatment and reduce the pain or suffering caused by the disease.

The first thing to learn is that angioedema, also called Quincke edema, can be life threatening. Symptoms of angioedema include swelling, usually painless, on any part of the body, vomiting, abdominal pain without any obvious reason, cramps and hydration.

If you have any of these symptoms, do not waste a single minute in consulting a doctor. If the swelling is painful or scorching, cool down the affected area with an ice pack or cloth dipped in cold water. Expose the affected area to sunlight and fresh air. Avoid the allergens and triggering factors, if you are allergic to certain foods try a food elimination technique. It might be time consuming but can be very helpful.

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Important facts about Idiopathic Angioedema and Idiopathic Urticaria Angioedema?

No doubt angioedema can be a real nuisance, but the most annoying form of angioedema is idiopathic urticaria angioedema or idiopathic angioedema because it has no known cause. However, don’t worry as this article will help you a great deal in understanding the situation and how you can cope with it.

Idiopathic angioedema treatment is more difficult to deal with because the cause is unknown. In more common cases a standard skin tests can reveal the culprit allergen.

The most commonly used drug, Epinephrine, has been a great success in cases of acquired angioedema treatment, but in hereditary angioedema the results may vary. There are several other drugs available for a patient with angioedema, but when it comes to the idiopathic form, you need to consult a qualified doctor.

You can read more about Idiopathic Angioedema and Idiopathic Urticaria Angioedema, by reading here.

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The most annoying form of angioedema is idiopathic urticaria angioedema or idiopathic angioedema as it occurs due to unknown causes. However, need worry not as this article will help you a great deal in understanding the situation and how you can cope with it. For a better understanding, let us understand the terms first separately: idiopathic urticaria angioedema.

Idiopathic means relating to, or designating a disease having no known cause. Urticaria is a skin rash characterized by occurring of red wheals, in response to allergic or non-allergic factors, which are usually itchy in nature. Angioedema is rapid swelling of skin, usually around lips and eyes, in response to allergic as well as non-allergic causes. So idiopathic angioedema is a type of angioedema with no known causes.

Idiopathic Angioedema Treatment

Idiopathic angioedema treatment is more difficult due to the fact that actual cause of the disease is unknown. In some cases standard skin tests can reveal the allergen, however, this method is hardly ever successful as the cause are often deep rooted.

As allergens or triggers can be a certain type of food, so a practicable approach is an elimination diet, however it is a long and time taking process. It is based on the exclusion of certain type of food or product from the everyday menu of the patient and see the response and this process is repeated with other food items.

The reasons for idiopathic angioedema are disreputably hard to identify because different kind of allergens are all around us, in the air we breathe in, in the water we drink. Certain seasons or climates may also be a factor.

Epinephrine has been a great success in case of acquired angioedema treatment, but in hereditary angioedema results may vary. Furthermore, in acquired angioedema antifibrinolytics such as tranexamic acid, hereditary angioedema types I and II, and non-histaminergic angioedema may be of use.

Certain therapies e.g. airway management can also be practices. Common patients not very sever conditions can be treated the same way as those of allergic angioedema. However, sever cases require intake of epinephrine, H1 and H2 blockers, and steroids in addition to the intake of antihistamines.

 


Hives Angioedema

Understanding Hives Angioedema?

Hives angioedema, though two completely different skin problems are very closely related to each other. Hives is a skin problem characterized by pale or pink raised wheals which sometimes are surrounded by a red halo and usually are itchy in nature.

Angioedema is a skin problem characterized by the rapid swelling of large areas of dermis or tissues just below the skin. It is not itchy in nature but the patient may feel a burning sensation.

Any of these two problems can cause extreme distress,  but having both of these at once can make life very difficult for the patient.  If you are having this problem, you need to get treatment from a doctor promptly.

Want to read more about hives angioedema? Read here.

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Hives, Angioedema; these two have a close association and sometimes are similar in appearance as well. Their evaluation and management, and the triggers are also pretty much the same. For better understanding of hives angioedema, let me define these two terms separately for you.

Hives is a skin problem characterized by the pale or pink raised swellings (welts) which sometimes are surrounded by a red halo and usually are itchy in nature. It is called urticaria in medical language so instead of hives angioedema we can also say urticaria angioedema. They can appear on any part of the body due to allergic as well as non-allergic causes. Acute hives vanish themselves within a few hours after their outbreak whereas the chronic hives may last up to years.

Angioedema is a skin problem characterized by the rapid swelling of large areas of dermis or tissues just below the skin. It is not itchy in nature but the patient may feel a burning sensation in the affected area. The swelling may occur anywhere but typically it is found around the eyes and lips. If the tongue and throat get swelled up, you should instantly consult a doctor as it can block the upper airway and can be life threatening.

There are some common triggers that may result in the outbreak of either hives or angioedema. These triggers include certain allergies (e.g. food allergy, pollen allergy), insect bites (e.g. a wasp or ladybug), autoimmune reactions and physical triggers (e.g. extreme temperature).

Hives and Angioedema

If hives and angioedema occur together they can create a great nuisance and can be severe. In most of the cases, angioedema and hives are undamaging and don not leave any permanent marks on the skin, sometimes you even do not need any treatment. On the other hand there are some severe cases which need to be treated as medical emergency. The most frequently opted for common treatment for both hives and angioedema is the ingestion of certain antihistamines which counter the effect of histamine release.

 


Hereditary Angioedema Attacks – ACEI Induced Angioedema

How to Manage Hereditary Angioedema Attacks and What is ACEI Induced Angioedema?

People suffering from angioedema want to know more about it and it’s certain subtypes. Many of them are searching for information about hereditary angioedema attacks and ACEI induced angioedema which is also called ACE inhibitor induced angioedema.

Hereditary angioedema occurs due the deficiency of C1 inhibitors and it passes down the family. Actually, hereditary angioedema attacks are recurrent episodes of pain that can make your life misery. On the other hand ACEI induced angioedema is caused by a diverse side effect of ACE inhibitor therapy. If you are developing the symptoms of angioedema during your therapy, an immediate withdrawal of the therapy must be followed by alternate drugs to control the situation.

Want to learn more about hereditary angioedema & ACEI angioedema? Read here.

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This article explains the basic details of hereditary angioedema attacks and ACEI induced angioedema (also called ACE inhibitor induced angioedema). For better understanding, the article is divided in two parts: the first one explains hereditary angioedema attacks whereas the second one entails ACEI induced angioedema. The major symptom of angioedema is the swelling caused which usually occurs on eyes and lips. This is why that sometimes it is also called facial angioedema.

Hereditary angioedema attacks are usually recurrent episodes of pain without any known or obvious cause. These attacks can be severely painful and disabling. These attacks typically cause severe abdominal pain and cramping in the abdomen. The symptoms are pretty much similar to these of acute abdomen hence can lead to an unnecessary keyhole or abdominal surgery.

The common and obvious sign of hereditary angioedema is swelling, that develops rapidly on the eyes, lips, tongue and sometimes throat. However, it is not limited to these areas, and can also be affect hands, feet, genitals etc. But in some cases the attacks of abdominal pain can be the sole symptom. Urticaria (hives) may also develop along with it. Severe swelling in the throat or tongue can cause blockage in the upper airway and even suffocation. The patient must avoid the triggering factors and proper diagnosis should be carried out before any treatment.

ACEI induced angioedema is bradykinin-mediated, just like in case of hereditary angioedema as well as acquired angioedema. It is outbreaks as an adverse effect of ACE inhibitor therapy. Thought it is very uncommon yet it can be life threatening and must be avoided. It symptoms can appear within a few weeks of months of the therapy however in most of the cases it takes years to appear. Black people are more prone to this disease as compared tow whites. If any symptom observed, an immediate withdrawal of ACE inhibitor is required which must be followed by long term alternate therapy with different drugs to keep hypertension and heart failure under control.

 


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