An overview of angioedema: Clinical features, diagnosis, and management
- Bruce Zuraw, MD
Bruce Zuraw, MD
- Professor of Medicine
- University of California San Diego
- Clifton O Bingham, III, MD
Clifton O Bingham, III, MD
- Associate Professor of Medicine
- Johns Hopkins University
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
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- CLINICAL FEATURES
- Types of angioedema
- Anatomic sites
- - Larynx
- - Lips, tongue, and uvula
- - Skin and mucous membranes
- - Bowel wall
- Life-threatening situations
- Clinical history
- Physical examination
- Laboratory tests
- - Isolated angioedema
- - Angioedema with prominent urticaria
- - Angioedema with anaphylaxis
- - Angioedema due to a suspect allergen
- Imaging for suspected bowel wall edema
- The utility of extensive empiric testing
- Idiopathic angioedema
- DIFFERENTIAL DIAGNOSIS
- Disorders resembling cutaneous edema
- Disorders resembling laryngeal edema
- Other causes of bowel wall edema
- Angioedema in or near the airway
- Angioedema with anaphylaxis
- Acute-allergic angioedema (less severe than anaphylaxis)
- ACE inhibitor-induced angioedema
- C1 inhibitor deficiency (hereditary angioedema)
- Recurrent, idiopathic angioedema
- DISPOSITION AND REFERRAL
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS