Angioedema (Child)

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 (AN-gee-oh-eh-DEE-muh). 

Allergic angioedema may be triggered by allergies to foods, drugs, latex, or insect stings. It can also occur in children with an infection or autoimmune disorders. Although it's rare, some children have a form of angioedema that is inherited. If your child has this form, your healthcare provider will tell you more about the condition and how to manage it.

Allergic angioedema occurs suddenly, within minutes to hours after exposure to an allergen. Swelling usually appears on the face, lips, mouth, throat, arms and legs, or genitals. The swelling is usually patchy and uneven. Allergic angioedema will usually come with other symptoms such as hives, itching, and redness of the skin. Angioedema that is not related to an allergy usually doesn't cause hives or itching. . In some cases, angioedema can affect the bowels and cause abdominal pain. The throat and airways in the lungs can also become swollen, causing difficulty breathing. These symptoms should be considered a medical emergency.

There are different types of angioedema. Your child's symptoms will depend on what type of angioedema he or she has. Swelling with or without itching or redness are the main symptoms. Other symptoms can include:

  • Rash, hives, redness, welts, blisters

  • Itching, burning, stinging, pain

  • Dry, flaky, cracking, scaly skin

  • Swelling of the face, lips, tongue, or other parts of the body

More severe symptoms include:

  • Trouble swallowing, feeling like the throat is closing

  • Trouble breathing, wheezing

  • Hoarse voice or trouble speaking

  • Nausea, vomiting, diarrhea, stomach cramps

  • Feeling faint or lightheaded, rapid heart rate, low blood pressure

The causes of angioedema may be similar to causes of allergic reactions. The most common causes of allergic angioedema can include:

  • Foods, including shrimp, shellfish, peanuts, milk products, gluten, eggs; also colorings, flavorings, and additives

  • Insect bites or stings from bees, mosquitoes, flees, and ticks

  • Medicines such as penicillin, sulfa medicines, aspirin and ibuprofen are common ; however any medicine can cause a reaction

  • 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

  • Stress

  • Heat, cold, sunlight

Home care

Woman giving liquid medication to boy.

  • The healthcare provider may prescribe medicines for itching, swelling, or pain. Follow the provider's instructions when giving these medicines to your child.

  • Unless a prescription antihistamine was prescribed, ask the healthcare provider if you can give your child diphenhydramine. Also ask what the recommended 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. 

  • Don't use diphenhydramine cream on your child's skin, because it can sometimes cause a rash and local reaction to the medicine.

  • Unless another pain medicine was prescribed, ask your healthcare provider if you can give your child acetaminophen or ibuprofen to control pain. Also ask what the recommended dose is and how often you should give the medicine to your child. 

  • Before giving your child any over-the-counter medicine, always check with your child's healthcare provider.

  • Medicines may have been prescribed to prevent your child's symptoms from returning. Give these as directed.

  • If your child is known to be allergic to something, do your best to avoid it. If the healthcare provider suspects that your child’s angioedema was caused by medicine your child takes regularly, he or she will discuss this with you.

  • Keep a record of what you child may have eaten or been exposed to before the reaction. Note similar reactions in other family members.

  • Apply cool compresses to areas that are bothersome. This will help reduce any irritation and itching.

  • Have your child wear loose cotton clothing. This will feel cooler to the skin and absorb moisture.

  • Have your child take a cool shower or bath. Temperature extremes can trigger a reaction.

  • Watch for signs of infection (see below).

General care

  • Make sure your child doesn't scratch areas of his or her body that had a reaction. This will help prevent infection. 

  • Help your child stay away from air pollution, tobacco and wood smoke, and cold temperatures. These can make allergy symptoms worse.

  • 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.

  • If your child has a serious allergy, have him or her wear a medical alert bracelet that notes this allergy. Or, carry a medical alert card for your baby.

  • If the healthcare provider prescribes an epinephrine auto injector kit, keep it with you or your child at all times. 

  • Tell all childcare providers and school officials about your child's allergy. Tell them how to use any prescribed medicine.

  • 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 recommendations on how to prevent future reactions.

When to seek medical advice

Call your child's healthcare provider right away or seek medical attention right away if any of these occur:

  • Symptoms don't go away

  • Symptoms come back

  • Symptoms get worse or new symptoms develop

  • Hives feel uncomfortable

  • Fever (see Fever and children, below)

  • Signs of skin infection such increasing redness, increasing pain, or foul-smelling drainage

Call 911

Call 911 if any of these occur:

  • Trouble breathing or swallowing or wheezing

  • Hoarse voice or trouble speaking or drooling

  • Chest pain or tightness

  • Confusion, lightheadedness, or dizziness

  • Trouble awakening or severe drowsiness

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Bloody vomit or large amounts of blood in stool

  • Seizure

  • Nausea, vomiting, diarrhea, abdominal pain, or stomach cramps

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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