Angioedema can be difficult to control
DEAR DOCTOR: My doctor diagnosed me with food-allergy-related angioedema and sent me to an allergist, who couldn’t find a cause. I’m afraid to eat anything because I never know when it’s going to flare up, making my tongue, lips and inner mouth around my gums swell.
DEAR READER:
Angioedema is an extreme swelling of the skin and sometimes other tissues. It occurs when fluid leaks from small blood vessels into the surrounding tissues, a process triggered by the release of inflammatory chemicals within the body. The swelling can be dramatic, especially when it occurs in the face and lips — even life-threatening when it affects the throat or bronchi or when a dilation of blood vessels leads to a severe drop in blood pressure.
Identifying a cause can be difficult. In 38-41 percent of people with angioedema, no cause can be found. In only 16 percent of people is a specific trigger identified. This can be a food, environmental allergen, insect bite or drug (besides ACE inhibitors). As for ACE inhibitors, these anti-hypertensive drugs are responsible for 11 percent
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When outbreaks do occur, they can be quickly stopped with the use of the steroid prednisone at 40 milligrams daily in addition to Benadryl.
Robert Ashley, M.D., is an internist and assistant professor of medicine at UCLA.