Angioedema (AN-gee-oh-eh-DEE-muh) is a sudden appearance of swollen patches (edema) on the skin or mucous membranes. It most often affects the face, lips, mouth, tongue, back of throat, or vocal cords. It may also occur in other places, such as the arms, legs, or genitals.
There are different types of angioedema. Sometimes angioedema is part of an allergic reaction (allergic angioedema). Other times angioedema is present without any other signs of allergic reaction (isolated angioedema). In rare cases, angioedema can run in families (hereditary angioedema). Sometimes the cause of the angioedema is never discovered (idiopathic angioedema)
Allergens are substances that cause allergies. They stimulate the body to release chemicals. These chemicals cause fluid to build up under the skin, causing swelling. If this inflammation causes the skin to swell, it's called angioedema.
Allergic angioedema may be triggered by allergies to foods, medicines, latex, or insect stings.
Allergic angioedema occurs suddenly, within minutes or hours after exposure to an allergen. Swelling often appears on the face, lips, mouth, throat, arms and legs, or genitals. The swelling is often patchy and uneven. Allergic angioedema will often come with other symptoms, such as hives, itching, and redness of the skin. Angioedema that isn't linked to an allergy usually doesn't cause hives or itching. In some cases, angioedema can affect the bowels and cause belly (abdominal) pain. The throat and airways in the lungs can also become swollen, causing trouble breathing. These symptoms should be considered a medical emergency.
Your child's symptoms will depend on what type of angioedema they have. Swelling with or without itching or redness are the main symptoms. Other symptoms can include:
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Rash, hives, redness, welts, blisters
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Itching, burning, stinging, pain
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Dry, flaky, cracking, scaly skin
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Swelling of the face, lips, tongue, or other parts of the body
More severe symptoms include:
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Trouble swallowing, feeling like the throat is closing
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Trouble breathing, wheezing
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Hoarse voice or trouble speaking
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Nausea, vomiting, diarrhea, stomach cramps
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Feeling faint or lightheaded, rapid heart rate, low blood pressure
Angioedema can be triggered by exposure to certain things. Medical conditions involving the immune system and certain infections may cause it. Sometimes the cause may be very clear. However, it's often hard to find a cause. Hereditary angioedema can happen after exposure to stress, dental procedures, trauma, or infection. The causes of angioedema may be similar to causes of allergic reactions. The most common causes of allergic angioedema include:
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Foods including shellfish, peanuts, milk products, gluten, and eggs. Also colorings, flavorings, and additives.
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Insect bites or stings from bees, mosquitoes, fleas, and ticks
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Medicines, such as penicillin, sulfa medicines, aspirin and ibuprofen. These are more common causes. But any medicine can cause a reaction.
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Latex in gloves, clothes, toys, balloons, or some tapes. Some people allergic to latex may have problems with foods like bananas, avocados, kiwi, papaya, or chestnuts
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Heat, cold, sunlight
Home care
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The healthcare provider may prescribe medicines for itching, swelling, or pain. Follow the provider's instructions when giving these medicines to your child.
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Unless a prescription antihistamine was prescribed, ask the provider if you can give your child diphenhydramine. Also ask what the advised dose is and how often you should give the medicine to your child. Diphenhydramine helps reduce itching if large areas of the skin are involved. It may make your child sleepy.
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Don't use diphenhydramine cream on your child's skin because it can sometimes cause a rash and local reaction to the medicine.
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Unless another pain medicine was prescribed, ask the provider if you can give your child acetaminophen or ibuprofen to control pain. Ask what the advised dose is. And ask how often you should give the medicine to your child. Never give more than prescribed.
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Before giving your child any over-the-counter medicine, always check with their healthcare or pharmacist.
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Medicines may have been prescribed to prevent your child's symptoms from returning. Give these only as directed.
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If your child is known to be allergic to something, do your best to stay away from it. If the provider suspects that angioedema was caused by medicine your child takes regularly, they'll discuss this with you.
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Keep a record of what your child may have done, eaten, or been exposed to before the reaction. Note similar reactions in other family members.
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Apply cool compresses to areas that are bothersome. This will help reduce any irritation and itching.
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Have your child wear loose cotton clothing. This will feel cooler to the skin and soak up moisture.
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Have your child take a cool shower or bath. Temperature extremes can set off a reaction.
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Watch for signs of infection (see below).
General care
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Make sure your child doesn't scratch areas of their body that had a reaction. This will help prevent infection.
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Help your child stay away from air pollution, tobacco and wood smoke, and cold temperatures. These can make allergy symptoms worse.
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Try to find out what caused your child's allergic reaction. Make sure to remove the allergen. Future reactions may be the same or worse.
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If your child has a serious allergy, have them wear a medical alert bracelet that notes this allergy. Or carry a medical alert card for your baby.
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If the healthcare provider prescribes epinephrine, always keep it with your child.
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Tell all childcare providers and school officials about your child's allergy. Tell them how to use any prescribed medicine.
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Keep a record of allergies and symptoms, and when they occurred. This will help your provider treat your child over time.
Follow-up care
Follow up with your child's healthcare provider, or as directed. Your child may need to see an allergist. An allergist can help find the cause of an allergic reaction and give advice on how to prevent future reactions.
When to get medical care
Call your child's healthcare provider right away if any of these occur:
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Symptoms don't go away
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Symptoms come back
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Symptoms get worse or new symptoms develop
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Hives feel uncomfortable
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Fever (see Fever and children, below)
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Signs of skin infection, such as increasing redness, increasing swelling, increasing pain, or foul-smelling drainage
Call 911
Call
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Trouble breathing or swallowing
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Wheezing
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Hoarse voice or trouble speaking or drooling
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Chest pain or tightness
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Confusion, lightheadedness, or dizziness
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Trouble waking up or severe drowsiness
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Fainting or loss of consciousness
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Rapid heart rate
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Bloody vomit or large amounts of blood in stool
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Seizure
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Nausea, vomiting, diarrhea, abdominal pain, or stomach cramps
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years old, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The healthcare provider may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.
Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.
Fever readings for a baby under 3 months old:
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First, ask your child’s healthcare provider how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
Fever readings for a child age 3 months to 36 months (3 years):
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Rectal, forehead, or ear: 102°F (38.9°C) or higher
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Armpit: 101°F (38.3°C) or higher
Call the healthcare provider in these cases:
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Repeated temperature of 104°F (40°C) or higher in a child of any age
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Fever of 100.4° (38°C) or higher in baby younger than 3 months
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Fever that lasts more than 24 hours in a child under age 2
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Fever that lasts for 3 days in a child age 2 or older
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