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Angio-oedema and anaphylaxis - Making a diagnosis
Symptoms and signs of angio-oedema
- Skin swelling is less well defined than in urticaria, and can affect the eyes, lips, genitalia, or hands and feet.
- The surface of the skin may appear normal.
- The swellings are often more painful than itchy, and last longer, taking up to 72 hours to resolve [Grattan et al, 2001].
- If there is systemic involvement:
- The person may have abdominal pain with nausea, vomiting, or diarrhoea.
- The person may be short of breath, with an associated wheeze (if there is swelling of the tongue or pharynx) which may suggest early anaphylaxis.
- Hereditary angio-oedema (HAE) is characterized by acute recurrent attacks, starting usually after puberty, and has a much slower onset than allergic angio-oedema:
- Gastrointestinal symptoms are common and can mimic an acute abdomen.
- Swellings normally affect the hands or feet, and are painless.
- Attacks last 1–4 days, and most people have one or more attacks per month.
- Up to 25% of people may have airway involvement.
[Kobza-Black and Champion, 1998]
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