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Urticaria and angioedema

Última revisão: 20 Aug 2025
Última atualização: 04 Dec 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • erythematous edematous lesions
  • pruritus
  • resolution within 24 hours
  • swelling of face, tongue, or lips
Detalhes completos

Outros fatores diagnósticos

  • blanching lesions
  • stridor
Detalhes completos

Fatores de risco

  • positive family history
  • female sex
  • exposure to drug trigger
  • exposure to food trigger
  • recent viral infection
  • recent insect bite or sting
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • CBC with differential
  • erythrocyte sedimentation rate (ESR)
  • CRP
  • C4 level
Detalhes completos

Tests to avoid

  • IgG testing
Detalhes completos

Investigações a serem consideradas

  • thyroid-stimulating hormone (TSH)
  • antinuclear antibodies (ANA)
  • skin prick testing
  • allergen avoidance diet
  • serum tryptase
  • skin biopsy
  • C1 esterase inhibitor level
  • C1 esterase inhibitor function
  • C1q levels
  • specific IgE to suspected allergen
Detalhes completos

Algoritmo de tratamento

AGUDA

acute urticaria ± angioedema

hereditary angioedema

CONTÍNUA

chronic urticaria ± angioedema

drug-induced angioedema without urticaria

idiopathic angioedema without urticaria

hereditary angioedema

Colaboradores

Autores

Jonathan Bernstein, MD

Professor of Medicine

Department of Internal Medicine

Division of Immunology/Allergy Section

University of Cincinnati

Cincinnati

OH

Declarações

JB is a consultant, contracted researcher, and speaker for Sanofi-Regeneron, AstraZeneca, Novartis/Regeneron, Genentech, Shire/Takeda, CSL Behring, Pharming and Biocryst. He is also a consultant and contracted researcher for Amgen, Allakos, Celldex, Kalvista, Biomarin and IONIS. JB is a consultant for Escient, Ono and Pharvaris, he is on the board of directors for AAAAI, and is a member of the Joint Task Force practice parameter. JB has spoken on this topic at National, International and Regional/Local Educational meetings. JB is an author of abstracts and manuscripts related to these topics and is an author of a number of references cited in this topic.

Agradecimentos

Dr Jonathan Bernstein would like to gratefully acknowledge Dr S. Shahzad Mustafa and Dr Stephen Dreskin, previous contributors to this topic.

Declarações

SM is on the speakers' panel and advisory board for Genentech. SD declares that he has no competing interests.

Revisores

Frances Humphreys, MB BS, FRCP

Consultant Dermatologist

Warwick Hospital

Honorary Associate Professor

University of Warwick

Warwick Hospital

Warwick

UK

Declarações

FH has attended educational events organised and funded by Almrall and Schering Plough; has received a speaker's fee from Steibel, Leo, and Schering Plough; and is an author of references cited in this topic.

Alexander M. Marsland, MRCP

Consultant in Dermatology

University Hospital of South Manchester

Manchester

UK

Declarações

None declared.

Luz Fonacier, MD

Head of Allergy and Training Program Director

Winthrop University Hospital

Associate Professor of Clinical Medicine

SUNY at Stony Brook

Stony Brook

NY

Declarações

LF declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Zuberbier T, Abdul Latiff AH, Abuzakouk M, et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022 Mar;77(3):734-66.Texto completo  Resumo

Fine LM, Bernstein JA. Guideline of chronic urticaria beyond. Allergy Asthma Immunol Res. 2016 Sep;8(5):396-403.Texto completo  Resumo

Powell RJ, Leech SC, Till S, et al. BSACI guideline for the management of chronic urticaria and angioedema. Clin Exp Allergy. 2015;45:547-565.Texto completo  Resumo

Maurer M, Magerl M, Betschel S, et al. The international WAO/EAACI guideline for the management of hereditary angioedema-The 2021 revision and update. Allergy. 2022 Jul;77(7):1961-90.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Urticaria and angioedema images
  • Diagnósticos diferenciais

    • Anaphylaxis
    • Dermatographism
    • Atopic dermatitis
    Mais Diagnósticos diferenciais
  • Diretrizes

    • The international WAO/EAACI guideline for the management of hereditary angioedema: the 2021 revision and update​
    • Guidelines for the management of people with chronic urticaria
    Mais Diretrizes
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