While exposure to allergens is a common cause of angioedema, it can also occur due to hereditary conditions. The cause of angioedema determines what type of treatments will be most effective.
The most simple description of angioedema is a swelling just beneath the skin, typically in areas of the body that have looser tissue, but it can penetrate deeper layers of the skin, as well. However, there are four distinct types of angioedema that may have slight variations in how they occur and how they appear.
- Allergic angioedema. Most cases of angioedema are a result of allergic reactions to something in a person’s environment. This type of angioedema can advance into more serious and life-threatening conditions, such as anaphylaxis and a sudden drop in blood pressure.
- Hereditary angioedema. Genetic anomalies occur in some families, typically involving an issue with what is known as a C1-inhibitor protein. Low levels of this C1-inhibitor protein in a person’s bloodstream can cause episodic angioedema.
- Drug-induced angioedema. Some types of medication, like ACE inhibitors that treat high blood pressure and hypertension, are known to cause angioedema for certain patients. Over-the-counter NSAIDS like ibuprofen and aspirin can also result in angioedema in some people.
- Idiopathic angioedema. When a cause cannot be identified, but the symptoms satisfy the diagnosis for angioedema, it may be called idiopathic angioedema. Because the cause cannot be clearly identified, it may be difficult to choose an effective treatment.
If a person is experiencing any type of angioedema, they should seek medical attention to avoid any complications and to receive an appropriate diagnosis and treatment.
Treatments for Angioedema
The type and severity of angioedema will dictate what treatment a doctor chooses and how urgently a treatment is administered. If angioedema has progressed to the point of a swollen and blocked airway, a breathing tube may be necessary to stabilize a person before medication can be given to them.
In less urgent situations, allergic or drug-induced angioedema may be simple and straightforward to treat. Allergic reactions may be relieved by removing the allergen from the environment and using epinephrine, antihistamines or corticosteroids to control the physical symptoms of angioedema.
Once a person stops taking the medication that causes drug-induced angioedema, they may see rapid results or they may need to wait for their body to finish metabolizing the medication before swelling goes down. In cases where the reaction to the medication is severe or may be life threatening, a patient may be admitted into a hospital to receive fluids that help their body rid itself of the medication faster.
In cases of hereditary angioedema, patients may need a concentrated form of the C1-inhibitor they’re missing or plasma transfusions that help them combat the symptoms of their genetic disorder.
Medicare Coverage for Treatment of Angioedema
When it comes to treatment options for angioedema, the circumstances of the treatment may dictate how Medicare decides which coverage rules apply. No matter what the cause of the angioedema may be, if the treatment for it is administered in an outpatient office visit, Medicare benefits through Part B may cover the cost of the treatment minus any applicable copay, coinsurance or deductible amounts.
Medicare recipients who receive angioedema treatment while classified as an inpatient at a hospital should expect Medicare benefits through Part A to determine how much of the treatment is covered and how much out-of-pocket expenses they’re obligated to pay.
If Medicare recipients receive a prescription for self-administered medication they take at home, they will need to purchase a standalone Part D prescription drug plan or a Medicare Advantage plan that includes a Part D prescription drug plan in its package for coverage of their medication. These plans classify medications accord to tiers, based on cost, so recipients should check the formulary of any plan to see whether their medication is covered and which tier is assigned to that medication.