Angioedema severity and impact on quality of life: chronic histaminergic angioedema versus chronic spontaneous urticaria
Nuria Rodríguez-Garijo 1 , Marina Sabaté-Brescó 2 , Julián Azofra 3 , Maria Luisa Baeza 4 , Camen Diaz Donado 3 , Pere Gaig 5 , Mar Guilarte 6 , Valeria Herrera-Lasso 5 , Moisés Labrador-Horrillo 6 , Anna Sala-Cunill 6 , Beatriz Veleiro 7 , Maria Pilar Gil 1 , Marta Ferrer 8
Histamine-mediated angioedema is the most frequent form of angioedema. It is classified as idiopathic histaminergic acquired angioedema (IH-AAE)1 when allergies and other causes have been excluded and a positive treatment response to antihistamines, corticosteroids, or omalizumab has been reported.
Idiopathic histaminergic acquired angioedema may occur in isolation, when it is termed chronic histaminergic angioedema (CHA), or it may be associated with wheals in chronic spontaneous urticaria angioedema (CSU-AE). The term CHA is equivalent to IH-AAE and mast cell-mediated angioedema.
However, this term reflects the chronic and recurrent course of the disease. Therefore, we propose that the term CHA be internationally discussed in the following guidelines. Chronic spontaneous urticaria is classically characterized by the presence of recurrent episodes of wheals (hives) with or without angioedema for at least 6 weeks.2 Chronic histaminergic angioedema is typically considered a subtype of CSU without wheals.
However, a recent study3 found several features that differentiate CHA from CSU, which suggests that CHA is a separate entity. Quality of life (QoL) studies specifically for CHA patients have not been performed, and their QoL has been assessed only in the context of CSU-AE.