Quincke's edema (angio-edema, giant urticaria, trophoneurotic edema, angioedema) is a sudden sudden allergic reaction of the body, characterized by massive swelling of the mucous membranes, skin and subcutaneous fat. Quincke's edema usually develops on the neck, upper body, face, back of the feet and / or brushes. Quite often, Quincke's edema affects the internal organs, joints and membranes of the brain. This pathological manifestation can develop absolutely in any person, but most often occurs in young women and in children
Quincke's Edema - Causes
There are two types of Quincke edema: pseudoallergic and allergic.
The development of pseudoallergic edema of Quincke is due to the congenital pathology of the compliment system. система комплимента это белки крови, участвующие в развитии первичных аллергических и иммунных реакций. For reference: the compliment system is the blood proteins involved in the development of primary allergic and immune reactions. These proteins in the human blood are in an inactive state, being activated exclusively in case of penetration of a foreign antigen in the place of the penetration itself. With Quincke's pseudoallergic edema, the compliment system can be activated both spontaneously and in response to chemical or thermal stimuli, leading to the development of an extensive allergic reaction.
Quincke's allergic edema, as in other and allergic reactions, arises from the body's immune response to the penetration of a specific allergen. Quite often allergic edema accompanies such diseases as hay fever , hives, bronchial asthma and food allergies .
Quincke edema in infants and young children is extremely rare. Predisposing factors in the development of this pathological condition can be diseases of the thyroid gland, liver, stomach, parasitic and autoimmune diseases and blood diseases. Quite often angioneuroticeski swelling gets a recurring chronic course. Quite often the exact cause of the edema of Quincke can not be established
Quincke's Edema - symptoms
The disease always begins suddenly. In a few minutes (less often hours) in different parts of the face and mucous membranes, there is a development of pronounced edema. Typical symptoms of Quincke edema are local swelling of the oral mucosa (tonsils, soft palate, tongue), eyelids, lips, scrotum, genitourinary tract, gastrointestinal tract, respiratory tract. Rarely, edema is accompanied by painful sensations, manifested by a feeling of tension in the tissues. The skin in the area of the edema is pale, itching is usually absent. In the region of the edema, the tension of the tissues is palpable when palpation, the pits do not remain with pressure, the swelling itself is painless.
The main places of localization of the edema of Quincke are the larynx, cheeks, eyelids, lower lip. The most dangerous form for the life of Quincke edema is edema of the trachea, larynx and pharynx, which is observed in 25% of all patients with this pathology. In such patients, aphonia develops, cyanosis of the tongue is observed, difficulty breathing occurs, anxiety occurs, and loss of consciousness is possible. When examining the mucous throat, there is swelling of the palatine arches and soft palate, the lumen of the throat is narrowed. If the swelling spreads to the trachea or larynx, a fatal outcome is possible due to suffocation.
If the swelling of Quincke affects the internal organs, the symptomatology is manifested by vomiting, diarrhea, sharp pains in the abdominal region. With the defeat of the meninges and brain develop neurological disorders (hemiplegia, aphasia, epileptiform seizures).
Quincke's edema in children manifests itself as delimited edematous foci on the mucous membranes and skin integuments.
Quincke's edema disappears without a trace after a few hours or days, but often recurs periodically
Possible complications with Quinck's swelling
Perhaps the most threatening complication is laryngeal edema with the growing symptoms of acute respiratory failure, which include a progressive difficulty in breathing, barking cough and hoarseness.
In case of defeat of the edema of the urogenital system, the symptomatology of acute cystitis appears. In addition, edema can lead to an acute retention of urine.
With edema of the gastrointestinal mucosa, a simulation of acute abdominal pathology may occur, dyspeptic disorders may occur, and intestinal peristalsis may increase. Symptoms of peritonitis and acute pain in the abdomen can often be observed.
In the case of localization of the edema on the face, the brain envelopes with the appearance of meningeal symptoms and signs of Meniere's syndrome (vomiting, nausea, dizziness ) may be involved in the process. In the absence of timely qualified emergency care? Quincke's swelling of this localization often entails a fatal outcome.
Diagnosis of Quincke edema is carried out on the basis of the presence of characteristic visual manifestations and the reaction of edema to the injected adrenaline. It is very important in the diagnostic process to determine the root cause, which has become a catalyst for the development of edema, for which the skin allergological tests and laboratory blood tests are usually used. It is also necessary to make differential diagnosis with Melkerson-Rosenthal syndrome, erysipelas, collateral edema with periostitis and lymphostasis
Edema Quincke - First Aid
• With edema of the mucosa of the respiratory tract (asphyxia) - adrenaline injections
• With a decrease in blood pressure, a subcutaneous injection of 0.1 to 0.5 r-adrenaline
• Desensitizing treatment. It consists in taking antihistamines: intramuscularly 2 ml of 2% suprastin, orally Telfast, Erius, Zirtek, Claritin
• Hormone therapy: glucocorticoids (intravenously from 8 to 12 mg of dexazone, intramuscularly from 60 to 90 mg of prednisolone)
• Preparations of protease inhibitors
• Detoxification therapy (enterosorption, hemosorption)
• Obligatory hospitalization in the department of allergology
Stepwise treatment of Quincke edema
• The primary therapeutic stage is the mandatory elimination of direct contact with a provoking allergen
• In order to increase the tone of the sympathetic nervous system, calcium preparations, etidrin, ascorbic acid
• To lower the level of histamine, Tavegil, Suprastin, and DiMedrol are prescribed. Parasympathetic activity is reduced with atropine
• To reduce vascular permeability, vitamin therapy (Ascorutin and others)
• The course of treatment with gamma globulin and group B vitamins, as well as desensitizing therapy with Prednisolone, Cortisone and ATKG
• To treat the hereditary edema of Quincke, drugs are used that enhance the production of the missing C-1 inhibitor
Prevention of edema Quincke implies strict adherence to a diet in which there are no food products that can cause the development of an allergic reaction. In case of forced contact with allergens, it is necessary to take prescribed antihistamines in a timely manner.