Angioedema refers to deep-tissue swelling with different causes. Angioedema is like hives (urtica) under the skin and is most commonly caused by an allergic reaction to a trigger and lasts a few minutes to a few days.

This article will explain what you need to know about types of angioedema, who is at risk for it and why, and the importance of screening and early detection.

Overview

Angioedema is a swelling (edema) of the tissue layer located under the skin or mucous membrane. It most commonly affects soft tissues on the eyelids, mouth, or genitals but can also affect the lungs, digestive tract, arms and legs, and throat.

How Common Is Angioedema?

The prevalence of angioedema varies depending on its cause.  Hereditary angioedema (HAE) is a rare type of angioedema. It affects an estimated 1 in 50,000 people in the United States.

Acquired angioedema or AAE is even less common. It is a nonallergic type that affects an estimated 1 in 100,000 to 1 in 500,000 people.

Angioedema by Ethnicity 

Black Americans have a higher rate of incidence than other U.S. populations for a type of angioedema called angiotensin converting enzyme (ACE) inhibitor angioedema, or ACEI angioedema.

Allergic angioedema is the most common type of angioedema. It’s responsible for an estimated 1 million emergency department visits in the United States each year.

This type of angioedema is associated with certain medicines, including a commonly prescribed blood pressure drug class called angiotensin-converting enzyme inhibitors such as Lisinopril and some blood pressure medications. Research reveals that with tens of millions of people taking ACEIs, the incidence of ACEI angioedema is rising.

Angioedema by Age and Gender

Significantly, half of all cases of angioedema occur in those aged 50, suggesting age plays a major role.

Gender differences play a well-documented role, too. It’s been said for decades that women with HAE experience worse symptoms and more attacks than men with HAE.

Causes of Angioedema and Risk Factors 

Common causes of angioedema and associated risk factors for triggers include allergies and conditions listed below:

The Role of Hormones

Conditions such as taking birth control pills (oral contraceptives) and experiencing hormonal changes associated with pregnancy can also trigger angioedema attacks in women.

  • Dander (skin flakes from animals) or pollen from plants
  • Sudden temperature changes
  • Certain foods such as shellfish, nuts, eggs, and dairy products
  • Insect or bug bites (i.e., venom)
  • Medications such as antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), and blood pressure medicines (ACE inhibitors)
  • Pollen from plants
  • Latex
  • Autoimmune diseases such as lupus
  • Cancers of the blood like leukemia

What Are the Mortality Rates for Angioedema?

Typically, angioedema isn’t life-threatening. When it causes swelling in the throat and mouth, or when it’s associated with allergy-triggered anaphylactic shock, though, it can lead to suffocation and can be fatal. Immediate assessment of the airway is critical to ensure breathing is not compromised due to swelling. Over the same time period, while other angioedema-related diseases remained rare, nonhereditary angioedema deaths reportedly increased.

Screening and Early Detection

Angioedema can become a medical emergency. Around 30% of sudden onset or acute angioedema cases are caused by ACE inhibitors. If you are taking ACE inhibitors, consider speaking to your healthcare provider about personal risk factors for angioedema.

Treating angioedema in a medical emergency typically requires:

When to See a Healthcare Provider

Angioedema can quickly worsen. Symptoms of shortness of breath, dizziness, and airway blockage can come on suddenly. If you suspect that you or someone you know is experiencing allergic angioedema and is having difficulty breathing, call 911 immediately.

  • Supplemental oxygen
  • Histamine blockers (antihistamines) to help narrow blood vessels
  • Medications including steroids and epinephrine to reverse severe allergic reaction

To determine the underlying cause of the angioedema attack, you may be offered lab tests including:

  • Genetic testingBlood testsAllergy tests

Summary

Angioedema is a deep-tissue swelling with several causes. Most cases of angioedema are caused by an allergic reaction, but there are other types that are much less common. These other types include hereditary angioedema and nonhereditary angioedema (i.e., acquired).

A Word From Verywell

Knowing you have an allergy or genetic condition isn’t always obvious. If you suspect angioedema, though, talk to a healthcare provider about prevention and treatment options. In cases of angioedema in the throat or mouth, seek immediate medical attention.