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Angioedema: Treatment

In cases where a specific trigger (allergen, medication, etc.) can be identified, that trigger must be removed to stop and prevent swelling in the future. In cases where the angioedema is related to a rheumatologic condition, the underlying condition must improve or be treated in order for the angioedema to improve. 

In severe or persistent cases of mast-cell mediated angioedema, medications such as antihistamines, steroids and even epinephrine are needed acutely to resolve the angioedema. Daily antihistamines are often used to help prevent recurrence of the angioedema, and people with facial swelling will often be given an EpiPen to carry with them in case of airway closure during an angioedema episode. If antihistamines are insufficient in stopping the angioedema, there are other immune suppressants that your doctor may want to try.  

Hereditary angioedema (HAE) and acquired angioedema (AAE) do not respond to these treatments. Although there are several possible therapies for HAE and AAE, the most effective intervention is to replace the missing or dysfunctional C1 esterase inhibitor enzyme, both in the immediate setting and also to prevent the spread of angioedema if episodes are occurring frequently enough. Some newer forms of medication include inhibitors of the bradykinin pathway—ecallantide and icatibant.   

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