Hereditary Angioedema

If swelling keeps coming back, especially without hives, it may be more than a routine allergy. One possible cause is hereditary angioedema (HAE), a rare condition that can cause swelling in the skin, stomach area, and sometimes the throat.

A Simple Overview

Hereditary angioedema is usually inherited and causes repeat swelling attacks. These attacks can happen in the hands, feet, face, lips, eyelids, genitals, or abdomen. Throat swelling is less common, but it is an emergency.

Many patients first think these episodes are allergies. HAE can look similar, but the pattern is often different and needs a different care plan.

Common Symptoms

People with HAE may have:

• Recurrent swelling without hives
• Swelling that feels tight, painful, or heavy (not usually itchy)
• Abdominal attacks with cramping, nausea, vomiting, or bloating
• Episodes that last longer than typical allergy swelling
• Lack of response to antihistamines, steroids, and epipen

How It Is Different From Typical Allergy Swelling

Typical allergy swelling often comes with hives and itching. HAE often does not.

If you keep having swelling with no clear allergy trigger, or repeated abdominal attacks, it is worth getting checked.

Emergency Warning Signs

Call 911 right away for:

• Trouble breathing
• Trouble swallowing
• Throat, tongue, or mouth swelling
• Voice changes
• Rapidly worsening facial swelling
• Do not wait to see if these symptoms improve at home.

What Can Trigger Attacks?

Triggers vary from person to person. Common ones include:

• Stress
• Illness
• Dental work or surgery
• Minor injury or pressure
• Some medicines, including estrogen-containing medicines and ACE inhibitors

Do not stop any prescribed medicine on your own. If you think a medicine may be related to swelling, speak with your prescribing clinician first.

How Diagnosis Works

Diagnosis starts with your symptom story and family history, then uses blood tests to look for signs linked to hereditary angioedema.

These blood tests check whether certain protective proteins in your immune system are low or not working well. Your specialist may also repeat tests, because results can vary depending on timing and symptoms.

Because HAE is rare, diagnosis can take time. Getting the pattern right is an important first step.

Treatment and Ongoing Care

Treatment depends on your symptoms and how often attacks happen. Care plans may include treatment for active attacks and prevention planning before known triggers like procedures. There are medications that can prevent attacks as well. It is important to establish a relationship with an allergist with clinical experience in HAE as new treatments are emerging including gene therapy.

The goal is to reduce symptoms, improve safety, and help you know what to do when symptoms start.

Next Steps

If recurrent swelling has affected your daily life, a specialist visit can help clarify what is going on and what testing makes sense.