Abstract
Purpose
Recurrent angioedema, characterized by skin swelling, colicky attacks of abdominal
pain, and life-threatening laryngeal edema, can be either hereditary or acquired.
According to anecdotal reports, it may be associated with use of oral contraceptives
and hormone replacement therapy. We investigated potential interactions between these
medications and various types of recurrent angioedema in a large cohort of women.
Methods
Women with recurrent angioedema (n = 516) underwent a thorough medical evaluation.
They were then classified by type of angioedema, using standard criteria.
Results
Of the 516 women, 228 (44%) had used oral contraceptives or hormone replacement therapy,
including 103 (45%) with urticaria-related angioedema, 50 (22%) with idiopathic angioedema,
39 (17%) with hereditary angioedema type III, 32 (14%) with hereditary angioedema
type I, and 4 (2%) with angioedema induced by angiotensin-converting enzyme inhibitors.
Oral contraceptives or hormone replacement therapy led to angioedema attacks in 46
women (20%), including 20 (63%) of the women with hereditary angioedema type I, 24
(62%) of those with hereditary angioedema type III, and 2 (4%) of those with idiopathic
angioedema. These 46 women included 26 in whom symptoms occurred for the first time
after use of these medications and 20 in whom pre-existing recurrent angioedema worsened
considerably.
Conclusion
Oral contraceptives or hormone replacement therapy can either induce or exacerbate
symptoms of hereditary angioedema type I or type III, or idiopathic angioedema. However,
many women with these diseases tolerate these medications without having any effects
on their angioedema.
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Article info
Publication history
Accepted:
September 18,
2002
Received in revised form:
September 18,
2002
Received:
January 9,
2002
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
