Angioedema Differential Diagnoses

Updated: May 17, 2018
  • Author: Huamin Henry Li, MD, PhD, CPI; Chief Editor: Michael A Kaliner, MD  more...
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DDx

Diagnostic Considerations

Special consideration should be given to those who experience angioedema without urticaria. In such cases, hereditary and acquired angioedema (AAE) must be differentiated. [14]

When angioedema is associated with urticaria, the diagnostic algorithm is almost identical to that of urticaria patients. For recurrent angioedema without urticaria, it is strongly recommended to rule out hereditary angioedema (HAE), angiotensin-converting enzyme inhibitor induced angioedema (ACEI-AAE, or AIIA), and acquired C1 esterase inhibitor deficiency angioedema (C1-INH-AAE). [49]

Except for ACEI-AAE (or AIIA), C1-INH-AAE, and different types of HAE, a significant proportion of angioedema can be adequately controlled with daily doses of nonsedating antihistamines. [14] Therefore, for angioedema without urticaria, and once C1 INH deficiency and ACEI-AAE are ruled out, empirical treatment with high doses of a second generation antihistamine (up to 4 times more than the conventional dose) can help further categorize the patients (histaminergic vs. nonhistaminergic).

Differential Diagnoses