Editing Angioedema (section)

{{Short description|Disease characterized by rapid swelling}}
{{Infobox medical condition (new)
| name            = Angioedema
| synonyms        = Angioedema, Quincke's edema, angioneurotic edema
| image           = Angioedema2010.JPG
| caption         = Allergic angioedema: this child is unable to open his eyes due to the swelling.
| field           = [[Allergy and immunology]], [[emergency medicine]]
| symptoms        = Area of swelling<ref name=Bern2017/>
| complications   =
| onset           = Minutes to hours<ref name=Bern2017/>
| duration        =
| types           = [[Histamine]] mediated, [[bradykinin]] mediated<ref name=Bern2017/>
| causes          =
| risks           = Family history<ref name=IAP2003/>
| diagnosis       = Based on symptoms<ref name=IAP2003>{{cite book|last1=Caterino|first1=Jeffrey M.|last2=Kahan|first2=Scott|title=In a Page: Emergency medicine|date=2003|publisher=Lippincott Williams & Wilkins|isbn=9781405103572|page=133|url=https://books.google.com/books?id=O0LwFPZDKbsC&pg=PA133|language=en|url-status=live|archive-url=https://web.archive.org/web/20170910152025/https://books.google.ca/books?id=O0LwFPZDKbsC&pg=PA133|archive-date=2017-09-10}}</ref>
| differential    = [[Anaphylaxis]], [[abscess]], [[contact dermatitis]]<ref name=IAP2003/>
| prevention      =
| treatment       = [[Intubation]], [[cricothyroidotomy]]<ref name=Bern2017/>
| medication      = '''Histamine''': [[antihistamine]]s, [[corticosteroid]]s, [[epinephrine]]<ref name=Bern2017/><br />'''Bradykinin''': [[C1 esterase inhibitor]], [[ecallantide]], [[icatibant]], [[fresh frozen plasma]]<ref name=Bern2017/>
| prognosis       =
| frequency       = ~100,000 per year (US)<ref name=Bern2017/>
| deaths          =
}}
<!-- Definition and symptoms -->
'''Angioedema''' is an area of swelling ([[edema]]) of the [[dermis|lower layer of skin]] and [[subcutaneous tissue|tissue just under the skin]] or [[mucous membrane]]s.<ref name=Bern2017/><ref name=Hab2009>{{cite book|last1=Habif|first1=Thomas P.|title=Clinical Dermatology E-Book|date=2009|publisher=Elsevier Health Sciences|isbn=978-0323080378|page=182|edition=5|url=https://books.google.com/books?id=kDWlWR5UbqQC&pg=PA182|language=en|url-status=live|archive-url=https://web.archive.org/web/20170910152025/https://books.google.ca/books?id=kDWlWR5UbqQC&pg=PA182|archive-date=2017-09-10}}</ref> The swelling may occur in the face, tongue, [[larynx]], abdomen, or arms and legs.<ref name=Bern2017/> Often it is associated with [[hives]], which are swelling within the upper [[skin]].<ref name=Bern2017/><ref name=Hab2009/> Onset is typically over minutes to hours.<ref name=Bern2017/>

<!-- Cause and diagnosis -->
The underlying mechanism typically involves [[histamine]] or [[bradykinin]].<ref name=Bern2017/> The version related to [[histamine]] is due to an [[allergic reaction]] to agents such as insect bites, foods, or [[medications]].<ref name=Bern2017/> The version related to bradykinin may occur due to an [[heredity|inherited]] problem known as [[C1 esterase inhibitor deficiency]], medications known as [[angiotensin-converting enzyme inhibitors]], or a [[lymphoproliferative disorder]].<ref name=Bern2017>{{cite journal|last1=Bernstein|first1=JA|last2=Cremonesi|first2=P|last3=Hoffmann|first3=TK|last4=Hollingsworth|first4=J|title=Angioedema in the emergency department: a practical guide to differential diagnosis and management.|journal=International Journal of Emergency Medicine|date=December 2017|volume=10|issue=1|pages=15|pmid=28405953|doi=10.1186/s12245-017-0141-z|pmc=5389952 |doi-access=free }}</ref>

<!-- Prevention and treatment -->
Treatment to protect the [[airway]] may include [[intubation]] or [[cricothyroidotomy]].<ref name=Bern2017/> Histamine-related angioedema can be treated with [[antihistamine]]s, [[corticosteroid]]s, and [[epinephrine]].<ref name=Bern2017/> In those with bradykinin-related disease a [[C1 esterase inhibitor]], [[ecallantide]], or [[icatibant]] may be used.<ref name=Bern2017/> [[Fresh frozen plasma]] may be used instead.<ref name=Bern2017/> In the United States the disease affects about 100,000 people a year.<ref name=Bern2017/>