Hydroxychloroquine dosing under 5 mg/kg/day is less effective in preventing lupus flares than higher dosing.
Department of Medicine
Allergy and Clinical Immunology Unit
Yawkey Center for Outpatient Care
55 Fruit Street, Yawkey 4B
Boston, MA 02114
Hours: Monday–Friday, 8:00 am to 4:30 pm
Explore This Treatment Program
Evaluation and Management of Angioedema (Swelling)
Angioedema refers to unexplained swelling that may involve any part of the body. Patients may experience angioedema alone or a combination of angioedema and hives (urticaria). There are a variety of different reasons for symptoms of swelling including:
- Hereditary angioedema with and without C1 inhibitor deficiency
- Acquired angioedema with C1 inhibitor deficiency
- Histamine and non-histamine mediated angioedema
- Associated with a known or allergic cause (e.g. drug allergy including ACE inhibitor, 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. In some cases, there is no identifiable trigger, and some forms of angioedema may require lifelong medical management but our team will support you in the best way possible.
What to Expect at Your Initial Appointment
Your first appointment will be with one of our expert allergists. We offer virtual consultations as well. Your allergist will conduct an in-depth consultation that includes an evaluation of your medical history, including exposure to potential triggers, response to treatments previously used, review of prior laboratory testing 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 at Mass General
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 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
- Recommending the appropriate treatment
If you have a diagnosis of hereditary angioedema, Dr. Aleena Banerji (one of the few angioedema specialists in the New England area and nationally recognized in the field) will play an important role in your care.
Acquired Angioedema with C1 inhibitor deficiency
Patients with acquired C1 inhibitor deficiency can present with recurrent episodes of swelling. Acquired C1 inhibitor deficiency is a very rare condition that can be associated with lymphoma or other autoimmune conditions. It can diagnosed by clinical history and blood tests. The main goal of therapy is to understand the cause of your symptoms and develop the best management plan
Idiopathic Angioedema and Non-Histaminergic Angioedema
Idiopathic angioedema and non-histaminergic angioedema represent a wide spectrum of disease with varying degrees of severity and chronicity. For patients suspected of having idiopathic angioedema, we will complete a thorough evaluation to identify a cause and try different therapies in search of an effective treatment plan. Antihistamines may provide symptom relief in some patients with idiopathic angioedema.
Non-histaminergic angioedema remains a very rare disease for which there are no available laboratory tests to clearly define the disorder. Therapy is often difficult and various treatment options have been used which will be discussed with you as part of your care.
About This Program
Expertise in Diagnosis & Treatment
The Angioedema Program, led by Aleena Baneriji, MD, offers a full range of services at our downtown Boston campus and at Mass General Waltham.
The treatment options for hereditary angioedema have improved significantly in the past decade. The Mass General Allergy Unit has participated in the study of several important novel therapies for treating hereditary angioedema, including:
- A bradykinin receptor antagonist
- C1-inhibitor replacement therapy
- Kallikrein inhibitor therapy
We continue to actively participate in ongoing clinical trials of novel therapies for patients with hereditary angioedema and enroll patients regularly. Our group's experience with these new medications leaves us uniquely skilled in determining the best way to manage your symptoms if you have a diagnosis of hereditary angioedema we focus on building a strong patient-physician relationship focused on individualized care with the goal of improving quality of life and decreasing burden of disease.
Leadership in the Angioedema Field
Aleena Banerji, MD, an Associate Professor in our group specializing in angioedema, is known nationally for her clinical and research expertise in this disorder. She is one of the few angioedema specialists in the Northeast and has been treating angioedema patients for 20+ years.
In addition, Dr. Banerji has been regularly involved in research studies of novel treatments for hereditary angioedema. Under her guidance, Mass General has participated in numerous clinical trials improving the care of patients with hereditary angioedema.
Dr. Banerji continues to lead groundbreaking research efforts and to incorporate the latest advances into her clinical practice whenever possible.
Meet Our Angioedema Specialists
- Associate Professor at Harvard Medical School
- Director, Drug Allergy Program
- Clinical Director, Allergy and Clinical Immunology
Related News and Articles
- Press Release
- Aug | 22 | 2022
Study results suggest that certain ant-cancer drugs may also target a key player in Crohn’s disease.
- Press Release
- Apr | 27 | 2022
Researchers uncover how the immune system clears, or in some cases helps, bacteria after infection.
- Press Release
- Nov | 2 | 2021
Researchers describe how macrophages promote various diseases, and identify drugs that can prevent this activity.
- Press Release
- Oct | 26 | 2021
New research addresses ongoing concerns regarding risks of allergic reactions after receiving mRNA COVID-19 vaccines, particularly for individuals with a history of severe allergic reactions. The results provide reassurances of the vaccines’ safety.
- Press Release
- Aug | 10 | 2021
New research led by investigators at Massachusetts General Hospital (MGH) uncovers some of the key factors that are needed for survival of immune cells in the battle against cancer.
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.