Attack triggers

Most Hereditary Angioedema (HAE) attacks occur spontaneously with no apparent reason; however anxiety, stress, minor trauma, surgery, and illnesses such as colds and flu are triggers that have been documented in studies of Hereditary Angioedema (HAE) kindreds.

  • Attack Triggers

    Patients have also reported swelling in extremities following typing, prolonged writing, pushing a lawn mower, hammering, shoveling, and other physical activities.(1) The trauma associated with dental procedures is particularly dangerous for HAE patients, because it increases vulnerability to airway attacks.

    In women, menstruation and pregnancy seem to have a major effect on disease activity. Many female patients report an increase in the number of attacks during their menstrual periods. During pregnancy, some women note an increase in the frequency of attacks, while others have reported a decrease.
    Oral contraceptives and hormone replacement therapy (HRT) may cause an increase in the frequency and severity of attacks.(2)

    Angiotensin Converting Enzyme Inhibitors (ACE Inhibitors) are known to cause bouts of angioedema in patients with normal C1 inhibitor levels. Because ACE inhibitors appear to affect a vasoactive peptide that is believed to be responsible for causing HAE swelling in C1 inhibitor deficient patients as well, specialists caution that these drugs should never be prescribed to HAE patients.

    (1) Frank MM, Gelfand JA, Atkinson JP. Hereditary angioedema: the clinical syndrome and its management. Ann Intern Med. 1976 May;84(5):581
    (2) Bouillet L, Hereditary angioedema in women. Allergy, Asthma and Clin. Immun. 2010;6(17)

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