Email updates

Keep up to date with the latest news and content from AACI and BioMed Central.

This article is part of the supplement: Practical guide for allergy and immunology in Canada

Open Access Highly Accessed Review

Urticaria and angioedema

Amin Kanani1*, Robert Schellenberg1 and Richard Warrington2

  • * Corresponding author: Amin Kanani

Author Affiliations

1 Division of Allergy and Immunology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

2 University of Manitoba, Winnipeg, Manitoba, Canada

For all author emails, please log on.

Allergy, Asthma & Clinical Immunology 2011, 7(Suppl 1):S9  doi:10.1186/1710-1492-7-S1-S9

Published: 10 November 2011

Abstract

Urticaria (hives) is a common disorder that often presents with angioedema (swelling that occurs beneath the skin). It is generally classified as acute, chronic or physical. Second-generation, non-sedating H1-receptor antihistamines represent the mainstay of therapy for both acute and chronic urticaria. Angioedema can occur in the absence of urticaria, with angiotensin-converting enzyme (ACE) inhibitor-induced angioedema and idiopathic angioedema being the more common causes. Rarer causes are hereditary angioedema (HAE) or acquired angioedema (AAE). Although the angioedema associated with these disorders is often self-limited, laryngeal involvement can lead to fatal asphyxiation in some cases. The management of HAE and AAE involves both prophylactic strategies to prevent attacks of angioedema (i.e., trigger avoidance, attenuated androgens, tranexamic acid, and plasma-derived C1 inhibitor replacement therapy) as well as pharmacological interventions for the treatment of acute attacks (i.e., C1 inhibitor replacement therapy, ecallantide and icatibant). In this article, the authors review the causes, diagnosis and management of urticaria (with or without angioedema) as well as the work-up and management of isolated angioedema, which vary considerably from that of angioedema that occurs in the presence of urticaria.