Hives and angioedema

3 imperatives to transform health care in America. You're invited to watch it live

Free

E-newsletter

Subscribe to Housecall

Our weekly general interest
e-newsletter keeps you up to date on a wide variety of health topics.

Sign up now

Causes

By Mayo Clinic staff

Hives and angioedema are caused by triggers that produce a skin or tissue reaction by stimulating certain cells (mast cells) to release histamine and other chemicals into your bloodstream.

Sometimes it's not possible to pinpoint the cause of hives and angioedema, especially when these conditions become chronic or recur.

Allergic reactions are one common trigger of acute hives and angioedema. Common allergens include:

  • Foods. Many foods can trigger reactions in people with sensitivities. Shellfish, fish, peanuts, tree nuts, eggs and milk are frequent offenders.
  • Medications. Almost any medication may cause hives or angioedema. Common culprits include penicillin, aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve, others) and blood pressure medications.
  • Other allergens. Other substances that can cause hives and angioedema include pollen, animal dander, latex and insect stings.

Additional triggers include:

  • Environmental factors. In some people, environmental factors can stimulate release of histamine. Examples include heat, cold, sunlight, water, pressure on the skin, emotional stress and exercise.
  • Dermatographia (also known as dermographia). The name of this condition literally means "skin writing." Stroking or scratching the skin results in raised red lines in the same pattern as the pressure.

Hives and angioedema also occasionally occur in response to blood transfusions, immune system disorders such as lupus, some types of cancer such as lymphoma, certain thyroid conditions, and infections with bacteria or viruses such as hepatitis, HIV, cytomegalovirus or Epstein-Barr virus.

Hereditary angioedema is a rare inherited (genetic) form of the condition. It's related to low levels or abnormal functioning of certain blood proteins (C1 inhibitors) that play a role in regulating how your immune system functions.

Risk factors Symptoms
References
  1. Kaplan AP. Urticaria and angioedema. In: Wolff K, et al. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aid=2958607. Accessed Sept. 13, 2010.
  2. MacNeal RJ. Urticaria. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec10/ch109/ch109e.html?qt=urticaria&alt=sh#sec10-ch109-ch109e-101c. Accessed Sept. 14, 2010.
  3. Bingham CO. New onset urticaria: Diagnosis and Treatment. http://www.uptodate.com/home/index.html. Accessed Sept. 29, 2010.
  4. Atkinson JP. Diagnosis of hereditary angioedema. http://www.uptodate.com/home/index.html. Accessed Sept. 29, 2010.
  5. Bingham CO. New onset urticaria: Epidemiology, clinical manifestations and etiology. http://www.uptodate.com/home/index.html. Accessed Sept. 29, 2010.
  6. Urticaria and angioedema. In: Wolff K, et al. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. 6th ed. New York, N.Y. The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=5187962. Accessed Sept. 14, 2010.
  7. Initial evaluation of all patients with urticaria. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, Scotland. Mosby/Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7234-3541-9..00015-8--s0180&isbn=978-0-7234-3541-9&type=bookPage&sectionEid=4-u1.0-B978-0-7234-3541-9..00015-8--s0180&uniqId=220753099-3#4-u1.0-B978-0-7234-3541-9..00015-8--s0180. Accessed Oct. 1, 2010.
  8. Treatment of urticaria. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, Scotland. Mosby/Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7234-3541-9..00015-8--s0290&isbn=978-0-7234-3541-9&type=bookPage&sectionEid=4-u1.0-B978-0-7234-3541-9..00015-8--s0290&uniqId=220753099-3#4-u1.0-B978-0-7234-3541-9..00015-8--s0290. Accessed Sept. 13, 2010.
  9. Acute urticaria: Evaluation and management. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, Scotland. Mosby/Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7234-3541-9..00015-8--s0185&isbn=978-0-7234-3541-9&type=bookPage&sectionEid=4-u1.0-B978-0-7234-3541-9..00015-8--s0185&uniqId=220753099-3#4-u1.0-B978-0-7234-3541-9..00015-8--s0185. Accessed Oct. 1, 2010.
  10. Bingham CO. An overview of angioedema: Clinical features, diagnosis and management. http://www.uptodate.com/index/home.html. Accessed Oct. 1, 2010.
  11. Delves PJ. Angioedema. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec13/ch165/ch165b.html. Accessed Oct. 1, 2010.
  12. FDA licenses for marketing new drug for rare genetic disease. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm161477.htm. Accessed Oct. 1, 2010.
  13. Cinryze. Food and Drug Administration. http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/LicensedProductsBLAs/FractionatedPlasmaProducts/ucm150480.htm. Accessed Oct. 6, 2010.
  14. Nolte H, et al. Overview of skin testing for allergic disease. http://www.uptodate.com/index/home.html. Accessed Oct. 2, 2010.
  15. Berinert. Food and Drug Administration. http://www.fda.gov/BiologicsBloodVaccines/BloodBloodProducts/ApprovedProducts/LicensedProductsBLAs/FractionatedPlasmaProducts/ucm186264.htm. Accessed Oct. 15, 2010.
  16. Kalbitor. Drugs @FDA. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm. Accessed Oct. 15, 2010.
  17. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 13, 2010.
DS00313 Dec. 21, 2010

© 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

  • Reprints
  • Print

  • Share on:

  • Email

Advertisement


Text Size: smaller largerlarger