24
3.17 Recognizing Prodromal Symptoms
as the First Sign of HAE Attacks
Some patients experience signs and/or symptoms that herald
the onset of an attack. These prodromal symptoms may
include sudden mood changes, irritability, aggressiveness,
anxiety, or extreme fatigue.
5,36
Others may notice a tingling
of the skin as the first sign of an attack.
10
Sensitivity to noise
or hunger pangs have also been recorded as prodromal
symptoms in the medical literature.
36
Bork et al noted that 70%of patients experienced prodromal
“Phase 0” symptoms as the first sign of an abdominal
attack. Although symptoms varied from patient to patient,
individual patients tended to repeatedly experience the
same prodromal symptom(s). Moreover, more severe
attacks were most likely to be preceded by prodrome.
36
Commonly reported in the literature is erythematous
mottling or erythema marginatum, a nonpruritic, serpi-
genous rash that heralds the onset of an HAE attack
(Figure 11).
5,10,36,42,56-58
Used with the kind permission of Michael M. Frank, MD, Department of Pediatrics, Medicine, and Immunology, Duke University School of Medicine, Durham, NC, USA.
Figure 11 – Erythema Marginatum in Hereditary Angioedema
