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Background: Most patients with chronic spontaneous urti- caria (CSU) exhibit recurrent angioedema. As of yet, the pathogenesis of angioedema in CSU is largely unclear, especially when angioedema occurs in patients who do not de- velop wheals. Over the past years, we and others have re- peatedly observed that patients with recurrent angioedema alone exhibit impaired glucose tolerance.

Aim: To assess blood glucose levels and glucose tolerance in these patients and to compare the results to those of CSU patients who do not develop angioedema.

Methods: A total of 29 patients with angioedema alone (15 women, mean age 43.2 ± 12.8 years) and 33 CSU patients (17 women, mean age 41.9 ± 17 years) were investigated and compared for clinical features and laboratory values, including fasting and random blood glucose levels, and glycated hemoglobin (HbA1c%). All patients were subjected to oral glucose tolerance testing (OGTT).

Results: Fasting plasma glucose levels, random blood glucose levels and OGTT glucose levels were signifi- cantly higher in patients with angioedema alone as com- pared to CSU patients. Glucose tolerance was impaired in 17 of 29 patients with angioedema alone (58.6%) and only in 2 of 33 CSU patients (6.1%). Patients were found to have an increased risk of high glucose (OR 1.74) and HbA1c (OR 1.83) blood levels and of developing a high BMI (OR 1.97).

Conclusion: Recurrent angioedema in patients who do not develop wheals appears to be associated with impaired glucose tol- erance and elevated blood glucose levels. We recommend blood glucose measurements in patients with recurrent angioedema alone.