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Distinguishing HAE from histamine-mediated angioedema

Management goals

Maintenance and treatment

Jonathan A. Bernstein, MD, discusses how to distinguish histamine-mediated angioedema from HAE based on symptoms, duration, and response to antihistamines and corticosteroids.

Transcript

Typically, histamine-mediated angioedema responds to H1 antihistamines and medicines that we use to treat urticaria.

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About 40% of patients with chronic hives can also have angioedema, but you could see patients with isolated angioedema that is responsive to medicines like antihistamines, corticosteroids, or glucocorticoids like prednisone, things of that nature.

Whereas patients with HAE, they have isolated swelling. It doesn’t itch, and it isn’t associated with hives, and it doesn’t come and go. It does stay for a longer period of time until the reaction resolves. And this is because it’s predominantly bradykinin-mediated. And that won’t respond to H1 antihistamines or glucocorticoids like, you know, prednisone.

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