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Angioedema Program

The Massachusetts General Hospital Angioedema Program provides expert evaluation and treatment of patients with all types of angioedema, including hereditary angioedema.

Treating Angioedema in All Its Forms

Angioedema refers to unexplained swelling of the soft tissues. It may involve any part of the body—most frequently, the lips, tongue and the soft tissues around the eyes. Patients may experience angioedema alone or a combination of angioedema and hives (chronic urticaria). Forms of angioedema include:

  • Hereditary
  • Acquired
  • Associated with allergic reactions (e.g. drug allergy, food allergy)
  • Idiopathic (i.e. of unknown cause)

Every angioedema patient's case is unique, so we tailor our diagnostic and therapeutic approaches based on your symptoms and medical history. Our goal is to identify the underlying cause of your angioedema, including what triggers it (when possible), and help you avoid these triggers. Some forms of angioedema may require lifelong medical management.

What to Expect

Your first appointment will be with Aleena Banerji, MD (one of the few angioedema specialists in the Northeast) or one of our other expert allergists. Your doctor will conduct an in-depth consultation that includes an evaluation of your medical history, including exposure to potential irritants, and a physical examination.

If hereditary angioedema is suspected, we will recommend blood tests for further evaluation. If food allergies are a possible cause of your angioedema, we will schedule food-allergy skin testing.

In many patients who are diagnosed with angioedema, the exact cause may not ultimately be identified. Patients with mild symptoms may not need any treatment. Those with more severe symptoms may benefit from medications for symptom relief. Your doctor will review the results of your blood tests (if applicable) and work with you to determine the most appropriate treatment regimen at your follow-up visit.

A Focus on Treating Hereditary Angioedema

The traditional therapy for hereditary angioedema includes the use of androgenic steroids taken daily. Recently, Mass General was extensively involved in the study of several important novel therapies for treating acute attacks of hereditary angioedema, including:

  • A bradykinin receptor antagonist (currently being investigated)
  • C1-inhibitor replacement therapy
  • Kallikrein inhibitor therapy

Our division's experience with these emerging medications leaves us uniquely skilled in determining which will be most effective for you.

Idiopathic Angioedema & Acquired Angioedema

Idiopathic angioedema represents a wide spectrum of disease with varying degrees of severity and chronicity. For patients suspected of having idiopathic angioedema, we also consider possible food and drug allergies and try different therapies in search of an effective solution. Antihistamines may provide symptom relief in some patients with idiopathic angioedema.

Acquired angioedema, which is diagnosed by clinical history and blood tests, can be associated with lymphoma or other autoimmune diseases. The main goal of therapy is to treat the underlying cause of the disease. Several novel therapies are under study at this time.

Expertise in Diagnosis & Treatment

The Angioedema Program, part of Mass General's Allergy and Clinical Immunology Unit, offers a full range of services at our downtown Boston campus and at Mass General West in Waltham.

Angioedema is an allergic condition that causes swelling beneath the skin and usually resolves within a few hours to a few days. Some patients may experience angioedema with hives (or chronic urticaria), an allergic condition that causes red, itchy and swollen areas on the skin's surface. Learn more about how we diagnose and treat hives.

Hereditary angioedema, a rare and sometimes life-threatening condition, can be triggered by stress, trauma and certain medications. In many cases, however, the trigger is not clear. The condition does not co-occur with hives.

Hereditary angioedema is often misdiagnosed as appendicitis or another abdominal disorder. As a result, some patients are treated for the wrong condition—and sometimes undergo unnecessary medical procedures, such as an appendectomy or abdominal surgery.

Our clinical and research experience means we are skilled in:

  • Recognizing hereditary angioedema and other forms of angioedema
  • Pinpointing the cause (when possible)
  • Recommending the appropriate treatment

In addition, as an academic medical center, Mass General can offer patients access to clinical trials of promising new drugs to treat hereditary angioedema.

Leadership in the Angioedema Field

Aleena Banerji, MD, our staff physician specializing in angioedema, is known nationally for her clinical and research expertise in this disorder. One of the few angioedema specialists in the Northeast, she has been treating angioedema patients since 2003.

In addition, Dr. Banerji has been regularly involved in developing and operating research studies of novel treatments for hereditary angioedema. Under her guidance, Mass General has completed clinical trials of C1-inhibitor replacement therapy. An ongoing clinical trial is exploring the efficacy and safety of a bradykinin receptor antagonist.

Dr. Banerji continues to lead groundbreaking research efforts and to incorporate the latest advances into her clinical practice whenever possible.

Educating the Next Generation

Our division is dedicated to preparing the next generation of great academic clinicians and basic scientists in allergy and immunology. Fellows in the Allergy and Immunology Training Program receive clinical and research training in angioedema and all other major conditions. Internal medicine residents also gain exposure to angioedema patients as part of their general training.

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