immunology allergic disorders
Angioedema
Symptoms and Signs of Angioedema
In angioedema, edema is often asymmetric and mildly painful. It often involves the face, lips, and/or tongue and may also occur on the back of hands or feet, on the genitals, or in the abdomen. Edema of the upper airways may cause respiratory distress and stridor; the stridor may be mistaken for asthma. The airways may be completely obstructed. Edema of the intestine may cause nausea, vomiting, colicky abdominal pain, and/or diarrhea. This photo shows acute swelling of the lips in a patient with hereditary angioedema. By permission of the publisher. From Joe E, Soter N. InCurrent Dermatologic Diagnosis and Treatment, edited by I Freedberg, IM Freedberg, and MR Sanchez. Philadelphia, Current Medicine, 2001. Angioedema of the lips can be asymmetric, as shown in this photo. DR P. MARAZZI/SCIENCE PHOTO LIBRARY This patient has a swollen tongue due to angioedema. SCIENCE PHOTO LIBRARY Other manifestations of angioedema depend on the mediator. Mast cell–mediated angioedema Tends to develop over minutes to several hours May be accompanied by other manifestations of acute allergic reactions (eg, pruritus, urticaria, flushing, bronchospasm, anaphylactic shock) Bradykinin-mediated angioedema Tends to develop over hours to a few days Is not accompanied by other manifestations of allergic reactions 