Angioedema symptoms

Last updated Nov. 28, 2023, by Marisa Wexler, MS
Fact-checked by Joana Carvalho, PhD

Angioedema refers to swelling that occurs when fluid builds up under the skin and/or in mucus membranes. While swelling is the defining symptom of angioedema, people also may experience other angioedema symptoms such as fatigue, abdominal pain, and breathing problems, the latter of which can be very serious.

Do angioedema symptoms vary by disease type?

There are different types of angioedema with different underlying causes. Some forms of angioedema occur due to genetic mutations (hereditary angioedema), while others occur as a result of an immune system dysfunction (acquired angioedema), an allergic reaction (acute allergic angiodema), or as a side effect to certain medications (drug-induced nonallergic angioedema), such as angiotensin-converting enzyme inhibitors. There also are instances where the underlying angioedema cause is unknown, which is referred to as idiopathic angioedema.

While all angioedema types are defined by swelling, specific patterns of swelling and other symptoms can vary across different types. For example, angioedema that results from exposure to an allergen (a substance that can trigger an allergic reaction) often causes itching or hives (urticaria), which are less commonly seen in most other forms of angioedema.

In other disease types, such as those associated with genetic mutations, patients also may experience certain signs and symptoms leading up to a swelling attack. These early signs of angioedema — often referred to as prodromal symptoms — may include erythema marginatum (a type of rash that’s not itchy), fatigue, muscle aches, tingling, and nausea.

The onset and frequency of symptoms also vary depending on the type of angioedema. For example, while symptoms of angioedema caused by an allergic reaction typically arise in the first hours or days following exposure to an allergen, those associated with the use of certain medications may take months or even years to manifest.

In turn, some forms of angioedema are associated with chronic recurrent attacks whose specific underlying cause may be more difficult to identify, especially in the absence of obvious triggers.

Swelling

Swelling is the defining symptom of angioedema, regardless of the underlying angioedema cause. It may affect any part of the body, but most commonly occurs in:

• face (lips, eyelids, mouth, or tongue)
• hands or feet
• neck or throat
• gut
• genitals.

Because the fluids that cause swelling gather in the deeper layers of the skin, angioedema generally manifests in large swollen areas of skin that may be smooth or raised. Unlike angioedema, hives are marked by swelling in the superficial layers of the skin, causing red, itchy wheals of varying sizes to appear on the surface of the skin.

The exact presentation of angioedema swelling varies from person to person, and even from case to case in the same person. Angioedema swellings can arise suddenly or gradually over a few hours; they can be red and hot to the touch or be no different in color from the surrounding skin; they also may be itchy or painful, or cause no discomfort at all.

Respiratory symptoms

When angioedema swelling occurs in the tongue, throat, or neck, it can obstruct the airways and make it harder for patients to breathe. This is considered the most serious complication of angioedema; it can be life-threatening and is a medical emergency that requires immediate medical attention.

Potential signs of swelling that may be obstructing the airways include:

• stridor (a harsh grating or vibrating noise while breathing)
• wheezing
• sudden and severe difficulty breathing and swallowing
• hoarseness and difficulty speaking
• dizziness, fainting, or collapse
• sudden confusion and tiredness
• the lips, tongue, or the palms of the hands turning blue, gray, or pale.

Gastrointestinal symptoms

In some cases, angioedema can affect the mucus membranes in and around the intestines, causing swelling in the gastrointestinal tract. This may manifest with symptoms including:

• abdominal pain or discomfort
• nausea or vomiting
• diarrhea
• abdominal distension (a swollen or bloated abdomen).

Angioedema episodes affecting the gastrointestinal tract can be very painful. Yet, their unspecific symptoms make these swelling attacks difficult to diagnose, and patients may experience chronic debilitating angioedema symptoms and undergo unnecessary procedures for several years before receiving an appropriate diagnosis and angioedema medications.

Angioedema News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.