Angioedema

A couple of weeks ago my 4 year old son woke up with an extremely swollen face.  The pediatrician thought it was a bug bite (despite the fact that there was no bite / puncture mark) or an allergy (insect or food).  We were given an Epi-Pen in case of breathing emergency, prescribed a daily dose of Zyrtec and told to re-visit our allergist.  The allergist did not think allergy testing for insects or food was necessary.  His diagnosis was Angioedema.

Angioedema (giant swelling) is large, sometimes distorting, swelling affecting the eyelids, lips, tongue or other parts of the body.  Very rarely Angioedema affects the throat, but when it does, it may be life threatening.  Giant swelling may occur with or without hives.  A very small percentage of these cases have an inherited or acquired deficiency of a blood protein that normally limits swelling.  When mast cells are reactive, scratching the skin can result in further release of histamine, making the problem worse.  Scratching induced hives (demographism or skin writing) are common.  When the precise cause of hives/giant swelling is identified, recurrence can be prevented by avoiding teh stimulus.  When no cause is found or avoidance is not effective or feasible, control of hives/giant swelling can often be accomplished with use of medications, even in chronic cases.  

My son had 6 episodes in 10 days (2 were extreme facial swelling - the others were single eye, side of lip, side of face / ear and one foot).  Since taking Zyrtec daily he hasn't had another extreme swell.


TIP:  Keep a log of time of day, frequency / duration of the swelling.  Consider food, insect bites, new detergents, materials, etc.  Log treatment used (ice pack, antihistamine, creams, etc).