Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

An overview of angioedema: Clinical features, diagnosis, and management

Bruce Zuraw, MD
Section Editor
Sarbjit Saini, MD
Deputy Editor
Anna M Feldweg, MD


Angioedema is self-limited, localized subcutaneous (or submucosal) swelling, which results from extravasation of fluid into interstitial tissues. Angioedema may occur in isolation, accompanied by urticaria, or as a component of anaphylaxis.

The clinical features, diagnosis, differential diagnosis, and management of angioedema will be reviewed here. The pathogenesis and causes of angioedema are discussed separately. (See "An overview of angioedema: Pathogenesis and causes".)


Angioedema typically affects areas with loose connective tissue, such as the face, lips, mouth, and throat, larynx, uvula, extremities, and genitalia. Bowel wall angioedema presents as colicky abdominal pain.

Angioedema can be distinguished clinically from other forms of edema by the following characteristics:

Onset in minutes to hours and spontaneous resolution in hours to a few days

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Nov 2017. | This topic last updated: Nov 21, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
  1. Agostoni A, Cicardi M. Drug-induced angioedema without urticaria. Drug Saf 2001; 24:599.
  2. Cugno M, Zanichelli A, Bellatorre AG, et al. Plasma biomarkers of acute attacks in patients with angioedema due to C1-inhibitor deficiency. Allergy 2009; 64:254.
  3. Joint Task Force on Practice Parameters. The diagnosis and management of urticaria: a practice parameter part I: acute urticaria/angioedema part II: chronic urticaria/angioedema. Joint Task Force on Practice Parameters. Ann Allergy Asthma Immunol 2000; 85:521.
  4. Caballero T, Baeza ML, Cabañas R, et al. Consensus statement on the diagnosis, management, and treatment of angioedema mediated by bradykinin. Part II. Treatment, follow-up, and special situations. J Investig Allergol Clin Immunol 2011; 21:422.
  5. Caballero T, Baeza ML, Cabañas R, et al. Consensus statement on the diagnosis, management, and treatment of angioedema mediated by bradykinin. Part I. Classification, epidemiology, pathophysiology, genetics, clinical symptoms, and diagnosis. J Investig Allergol Clin Immunol 2011; 21:333.
  6. Sánchez-Borges M, Asero R, Ansotegui IJ, et al. Diagnosis and treatment of urticaria and angioedema: a worldwide perspective. World Allergy Organ J 2012; 5:125.
  7. Zuraw BL, Bernstein JA, Lang DM, et al. A focused parameter update: hereditary angioedema, acquired C1 inhibitor deficiency, and angiotensin-converting enzyme inhibitor-associated angioedema. J Allergy Clin Immunol 2013; 131:1491.
  8. Alcoceba E, Gonzalez M, Gaig P, et al. Edema of the uvula: etiology, risk factors, diagnosis, and treatment. J Investig Allergol Clin Immunol 2010; 20:80.
  9. Califano L, Zupi A, Longo F, et al. Swelling of the floor of the mouth: a clinical dilemma. Acta Stomatol Belg 1996; 93:101.
  10. Dobbels P, Van Overbeke L, Vanbeckevoort D, Hiele M. Acute abdomen due to intestinal angioedema induced by ACE inhibitors: not so rare? Acta Gastroenterol Belg 2009; 72:455.
  11. Chase MP, Fiarman GS, Scholz FJ, MacDermott RP. Angioedema of the small bowel due to an angiotensin-converting enzyme inhibitor. J Clin Gastroenterol 2000; 31:254.
  12. Jacobs RL, Hoberman LJ, Goldstein HM. Angioedema of the small bowel caused by an angiotensin-converting enzyme inhibitor. Am J Gastroenterol 1994; 89:127.
  13. Arakawa M, Murata Y, Rikimaru Y, Sasaki Y. Drug-induced isolated visceral angioneurotic edema. Intern Med 2005; 44:975.
  14. Shahzad G, Korsten MA, Blatt C, Motwani P. Angiotensin-converting enzyme (ACE) inhibitor-associated angioedema of the stomach and small intestine: a case report. Mt Sinai J Med 2006; 73:1123.
  15. Gabb GM, Ryan P, Wing LM, Hutchinson KA. Epidemiological study of angioedema and ACE inhibitors. Aust N Z J Med 1996; 26:777.
  16. Greaves MW, Sabroe RA. ABC of allergies. Allergy and the skin. I--Urticaria. BMJ 1998; 316:1147.
  17. Bas M, Hoffmann TK, Bier H, Kojda G. Increased C-reactive protein in ACE-inhibitor-induced angioedema. Br J Clin Pharmacol 2005; 59:233.
  18. Vallurupalli K, Coakley KJ. MDCT features of angiotensin-converting enzyme inhibitor-induced visceral angioedema. AJR Am J Roentgenol 2011; 196:W405.
  19. Zingale LC, Beltrami L, Zanichelli A, et al. Angioedema without urticaria: a large clinical survey. CMAJ 2006; 175:1065.
  20. Kaplan AP, Greaves MW. Angioedema. J Am Acad Dermatol 2005; 53:373.
  21. Charlesworth EN. Differential diagnosis of angioedema. Allergy Asthma Proc 2002; 23:337.
  22. Israili ZH, Hall WD. Cough and angioneurotic edema associated with angiotensin-converting enzyme inhibitor therapy. A review of the literature and pathophysiology. Ann Intern Med 1992; 117:234.
  23. Kaneoya K, Momota Y, Hatamochi A, et al. Elastin gene expression in blepharochalasis. J Dermatol 2005; 32:26.
  24. Wang G, Li C, Gao T. Blepharochalasis: a rare condition misdiagnosed as recurrent angioedema. Arch Dermatol 2009; 145:498.
  25. Koursh DM, Modjtahedi SP, Selva D, Leibovitch I. The blepharochalasis syndrome. Surv Ophthalmol 2009; 54:235.
  26. Paul M, Geller L, Nowak-Węgrzyn A. Blepharochalasis: A rare cause of eye swelling. Ann Allergy Asthma Immunol 2017; 119:402.
  27. Dózsa A, Károlyi ZS, Degrell P. Bilateral blepharochalasis. J Eur Acad Dermatol Venereol 2005; 19:725.
  28. Van Dellen RG, Maddox DE, Dutta EJ. Masqueraders of angioedema and urticaria. Ann Allergy Asthma Immunol 2002; 88:10.
  29. Kakimoto C, Sparks C, White AA. Melkersson-Rosenthal syndrome: a form of pseudoangioedema. Ann Allergy Asthma Immunol 2007; 99:185.
  30. van der Waal RI, Schulten EA, van de Scheur MR, et al. Cheilitis granulomatosa. J Eur Acad Dermatol Venereol 2001; 15:519.
  31. Ledermann HP, Börner N, Strunk H, et al. Bowel wall thickening on transabdominal sonography. AJR Am J Roentgenol 2000; 174:107.
  32. Macari M, Megibow AJ, Balthazar EJ. A pattern approach to the abnormal small bowel: observations at MDCT and CT enterography. AJR Am J Roentgenol 2007; 188:1344.
  33. De Backer AI, De Schepper AM, Vandevenne JE, et al. CT of angioedema of the small bowel. AJR Am J Roentgenol 2001; 176:649.
  34. Dean DE, Schultz DL, Powers RH. Asphyxia due to angiotensin converting enzyme (ACE) inhibitor mediated angioedema of the tongue during the treatment of hypertensive heart disease. J Forensic Sci 2001; 46:1239.
  35. Cicardi M, Aberer W, Banerji A, et al. Classification, diagnosis, and approach to treatment for angioedema: consensus report from the Hereditary Angioedema International Working Group. Allergy 2014; 69:602.
  36. Kaplan AP. Clinical practice. Chronic urticaria and angioedema. N Engl J Med 2002; 346:175.
  37. González P, Soriano V, Caballero T, Niveiro E. Idiopatic angioedema treated with dapsone. Allergol Immunopathol (Madr) 2005; 33:54.
  38. Del Corso I, Puxeddu I, Sardano E, et al. Treatment of idiopathic nonhistaminergic angioedema with bradykinin B2 receptor antagonist icatibant. Ann Allergy Asthma Immunol 2012; 108:460.
  39. Ghazan-Shahi S, Ellis AK. Severe steroid-dependent idiopathic angioedema with response to rituximab. Ann Allergy Asthma Immunol 2011; 107:374.
Topic Outline