Recognizing the Onset of HAE Attacks

Attacks of hereditary angioedema (HAE) may occur suddenly and without warning. However, if you’re like many people with HAE, you may notice symptoms that precede an attack. These symptoms are called prodrome (PRO droam) or prodromal (pro DROAM ul) symptoms. As more medications are approved for the treatment of HAE, it may eventually be possible to thwart a full-blown attack by taking medication at the first sign of prodrome.

Some common prodromal symptoms reported by people with HAE are:

• Fatigue
• Tingling
• Nausea
• Rumbling, bowel movement changes
• Flu-like feelings
• Hives
• Non-itchy rash with pale colored centers

In a recent survey of people with HAE, some people noticed these symptoms minutes or hours before an attack, while others said they could feel them a day or two before the full attack began. In the survey, people with HAE most often reported tingling, fatigue, flu-like symptoms, and nausea. Some of these symptoms, such as nausea or changes in bowel movement, only occurred before abdominal attacks.

HAE attacks can be extremely serious—even life-threatening. The following symptoms can indicate a serious situation:

• Throat swelling can block the airway and is therefore life-threatening; such attacks require immediate emergency care. Some of the symptoms of throat swelling may include a hoarse voice, whistling or wheezing when breathing, a swollen tongue, cough, or shortness of breath. If you experience this type of attack, call your local emergency number.
• Intestinal swelling can cause intense, “colicky” abdominal pain that can progress to vomiting and diarrhea. Intestinal swelling is often misdiagnosed as an abdominal disorder, such as appendicitis, a bowel rupture, or an obstruction. An increase in a white blood count during an attack can make an accurate diagnosis difficult.