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Quincke's Edema: symptoms and treatment, first aid, complications, photo

According to historical data, Quincke's edema was first described in 1576 by Marcello Donati. However, the term angioedema was introduced in 1882 by Henryk Kvinke, whose name this condition still bears.

However, it was not until 1964 that chemicals were discovered that triggered the development of a pathological reaction. Since then, there has been an opportunity for targeted pathogenetic treatment.

Content

Edema Quincke - what is it?

Edema Quincke is one of the most difficult problems of allergology - this is due to the high prevalence of this pathology. So, its frequency in combination with urticaria is 49% among allergic reactions, and isolated angioedema is observed in 11% of cases.

Edema Quincke

Edema Quinck Photo 1

And the greatest prevalence is observed in persons of working age. It is worth noting that in 2% of cases, angioedema may be hereditary, associated with a certain pathological response of complement (a specific link of the immune system that protects a person normally from pathogenic microorganisms).

Quincke's Edema is a condition in which swelling of the skin and subcutaneous fat is observed. At the same time it can be combined with mucosal edema. Therefore, the respiratory, urinary, digestive and nervous systems can be affected, which leads to the appearance of the corresponding symptomatology (see photo).

Quincke's edema is characterized by some features of the symptoms:

  • A sudden appearance (at times it is not so easy to identify the causative agent);
  • Development of puffiness in the lower layers of the skin layer and fat;
  • Prevalence of soreness with minimal itching;
  • Frequent involvement in the pathological process of the mucous membranes;
  • Slow puffiness resolution - within 72 hours, in comparison with blisters with hives, which quickly pass.

). Clinical signs of Quincke's edema appear after contact with allergens, in their role can act different substances ( see the list at the bottom of the article ).

However, regardless of the causative factor, allergic edema and urticaria develop due to increased histamine formation in the body. This is confirmed by the following facts:

  • The appearance of characteristic skin reactions with the administration of histamine;
  • Proven release of granules from mast cells (macrophages);
  • Increased release of histamine in certain forms of urticaria;
  • The clinically proven effectiveness of antihistamines.

Symptoms of Quincke's Edema, photo

Symptoms of Quincke Edema

swelling and skin manifestations

Quincke allergic edema can be of 2 main types:

  1. Acute - suddenly appears when the causative factors get into the body;
  2. Acutely relapsing, when for at least 3 to 6 months there is at least 3 clinical relapses.

Symptoms of edema Quine have the following features:

  • Most often, the asymmetry of the lesion is noted;
  • The color is pale pink or does not differ from the color of the skin;
  • Rare identification of itching, more often there is pain and burning sensation;
  • For the suppression of clinical manifestations, it takes more than 24 hours;
  • The favorite localization are tissues, rich in water - the periorbital zone, the scalp, tongue, pharynx, brushes, genitals, feet (back surface). However, swelling can occur anywhere;
  • Skin manifestations can be combined with edema of the mucous membranes of any organ and joints.
Symptoms of angioedema in adults

Edema Quincke, photo, language - very dangerous condition

Symptoms in adults, with Quinck's swelling in the larynx, as a variant of angioedema, threaten life. Death comes because of suffocation.

With edema of the larynx, characteristic first signs are cough and hoarse voice, as it develops, noisy breathing and symptoms of suffocation are manifested.

With edema of the stomach and intestinal mucosa, there are characteristic symptoms - nausea, vomiting, pain in the abdomen of a spastic nature.

In some cases, there may be rare forms of Quincke edema, their symptoms:

Рецидивирующий, сочетающийся с гиперэозинофилией. 1) Recurrent, combined with hypereosinophilia. In this state, the number of eosinophils is several times higher than the norm for a given age period, and leukocytes and the level of antibodies directed against the endothelium (the inner shell of the vessels) are also increased.

Clinically determined elevated temperature to 40 ° C and skin allergic rash.

Наследственная форма отека Квинке, которая передается по аутосомно-доминантному типу. 2) Hereditary form of the Quincke edema, which is transmitted by an autosomal dominant type. Occasionally, there is edema of different locations. This disease is characterized by genetic deficiency of the protein, which inhibits the activation of complement.

For the first time the disease manifests itself at the age of up to 20 years. Before this period, clinical symptoms are absent. The main danger of the hereditary form is the increased risk of death, which is observed in 35% of patients. Therefore, all relatives are subject to inspection.

Приобретенная форма ангионевротического отека чаще встречается у пожилых пациентов и бывает связана с лимфопролиферативными заболеваниями, системной красной волчанкой и вирусным гепатитом. 3) Acquired form of angioedema is more common in elderly patients and is associated with lymphoproliferative diseases, systemic lupus erythematosus and viral hepatitis.

Hereditary forms of allergy can be of three main types:

  1. The first type is observed in 85% of cases. The causative mutation arises spontaneously, so the genotype usually remains normal with relatives;
  2. The second type is less common - in 15% of cases. It is associated with a high concentration of complement activators due to the fact that it is not consumed;
  3. The third type is observed only in women, tk. the disease is linked to the X chromosome. This form has been described recently.

For the hereditary form of angioedema, the following features are characteristic:

  • Frequent association with chronic infection;
  • Recurrent occurrence of edema;
  • Frequent pain in the abdomen, combined with nausea and vomiting (they can cause unreasonable surgical interventions);
  • Reduced content of C4-fraction of complement (an important diagnostic feature, because at its normal values ​​the probability of hereditary form is minimal);
  • Absence of itching;
  • Frequent development of laryngeal edema with involvement in edematic syndrome and language;
  • Rarely there is urticaria;
  • Exacerbations are repeated at different intervals. In some patients - once a week, in others - once a year.

Quincke edema in children - features

Quincke edema in children

signs of edema in children, photo

Symptoms of Quincke's edema in children are somewhat different from adults - this requires utmost care from parents. The appearance of any suspicious symptoms should be an occasion for consultation with a doctor.

Features of edema in childhood are:

  • The possibility of manifestation in any part of the body, and not only hydrophilic (containing a large amount of water);
  • Frequent appearance of rashes on the skin as a urticaria ;
  • Excited state;
  • Increased temperature, loss of consciousness;
  • Pain in the abdomen, nausea and vomiting.

Symptoms of Quincke edema in children

Quincke's swelling in a child is often accompanied by a larynx lesion. This is fraught with deadly choking if not helped in time.

First aid for swelling of Quincke

First aid for swelling of Quincke

The first aid for swelling of Quincke includes the following activities:

  1. Obligatory call of an ambulance with a description of the situation;
  2. Stop the intake of the allergen in the body;
  3. When an insect bites, an ice pack is placed on this place, and above the place of the bite, a pressure bandage is applied, which prevents further ingestion of the allergen into the bloodstream;
  4. Gastric lavage and administration of activated charcoal if edema is associated with food;
  5. Provide oxygen to the room (open the window);
  6. Give to take any antihistamine. However, in the presence of edema of the mucosa of the digestive tract, its absorption is disturbed, so intravenous or intramuscular injection is required (this is done by ambulance doctors).

If Quincke's swelling in a person repeats, then he already has specially prepared syringes with adrenaline and a hormonal drug. They are manufactured by the pharmaceutical industry.

Treatment of angioedema, drugs

Treatment of edema Quincke drugs

Priority in the treatment of edema Quincke and anaphylactic shock occupy second-generation antihistamines. Their effectiveness is due to the suppression of histamine synthesis and its action with receptors. An additional effect is anti-inflammatory.

Representatives of antihistamines of the first generation are:

  1. Diphenhydramine;
  2. Tavegil;
  3. Pipolphen;
  4. Suprastin;
  5. Fenistil;
  6. Diazoline;
  7. Fenkarol.

However, the second generation of drugs for the treatment of edema Quincke is preferable, it includes:

  1. Claritin;
  2. Zirtek;
  3. Telfast;
  4. Erius.

At the same time, it is recommended to create a hypoallergenic life:

  • As much as possible to remove as much as possible from the premises extra things that accumulate dust (carpets, soft toys and others);
  • Use of special anti-allergic covers for pillows, mattresses and blankets. Synthetic covers in insufficient volume protect against ticks parasitizing in down;
  • Bed linen should be washed at a temperature above 60 ° C, so that all mites that can remain in it are lost;
  • If there are carpets in the house, they should be treated with special acaricides (benzyl benzoate, methylpyrimiphos);
  • Heavy curtains should be replaced with cotton or linen, washed in hot water;
  • Wipe the furniture with a damp cloth;
  • Furniture with upholstery should be vacuumed 2 times a week;
  • Do not over-moisten the air; this creates good conditions for the life of ticks;
  • Detergent vacuum cleaner protects against the smallest particles that can cause allergies;
  • Do not let a child take fur toys into bed;
  • Fur toys should be washed or frozen in the freezer;
  • Abandon pets and birds;
  • Remember that fungi that lead to mold can multiply in flower pots;
  • Ventilate the room every day;
  • Books, linens and clothes should be stored in closed closets;
  • Watch for the appearance of damp spots on the ceilings and in the corners.

Symptoms and treatment of Quincke's edema directly depend on nutrition - therefore a hypoallergenic diet is recommended. Its main principles are:

  • Complete exclusion of highly allergenic products (coffee, chocolate, eggs, cocoa, fruits, vegetables and berries, having orange and red color);
  • Complete elimination of allergens that cause angioedema;
  • Adequate replacement of excluded products to meet human needs for energy and nutrients;
  • Step-by-step expansion of the diet with the introduction of banned products in small doses and an assessment of individual tolerability;
  • Prohibited acute and extractive substances - broths, canned food, smoked foods, pickles, etc .;
  • Prohibited foods containing food additives (marmalade, pastille, marshmallows, cakes, etc.);
  • Limit salt, flour products and butter;
  • Fruits and berries of light color are allowed;
  • Rice, buckwheat, pearl barley is allowed;
  • Dairy products are used;
  • You can eat turkey meat and rabbits;
  • Allowed vegetable oils;
  • Food should be steamed or boiled;
  • Cereals and potatoes should be pre-soaked for 18 hours before cooking;
  • The first water in the cooking of meat should be drained.

Complications

Complication of the Quincke edema of the larynx

The most dangerous complication of Quincke's edema is the laryngeal edema that leads to asphyxia. As a result, acute respiratory failure can result in death if treatment is not performed on time. Other complications of angioedema are:

  1. Acute abdominal syndrome, simulating the surgical pathology of the abdominal cavity;
  2. Acute allergic cystitis leading to acute urinary retention;
  3. Mineral syndrome with swelling of the inner ear mucosa (this is a manifestation of dizziness and noise in the ears);
  4. Combination of edema with hives.

The causes of Quincke's edema are frequent allergens

Among food products, the most dangerous are: fish, eggs, milk, chicken, beef, apples, nuts, pork, honey, carrots, stone
citrus, melon, smoked, various food additives and soy products.

Medications can also be powerful allergens. In this respect, the greatest danger is represented by:

  • penicillins from the group of beta-lactams;
  • cephalosporins;
  • non-steroids, especially aspirin;
  • B-vitamins;
  • angiotensin enzyme blockers;
  • retngencontrast preparations;
  • insulin.

The poison of bees, wasps and hornets also has strong allergenic properties. With him on strength are comparable and some infections:

  • Hepatitis C and B, HIV infection;
  • Diseases associated with the Epstein-Barr virus and Coxsackie;
  • Herpetic infection;
  • Helicobacter pylori diseases;
  • Infectious mononucleosis;
  • Dysbacteriosis of the intestine;
  • Chronic bacterial and fungal conditions.

Some autoimmune diseases and parasitic infestations can also become provocateurs of Quincke's edema:

  • Sjogren's syndrome, lupus erythematosus, thyroiditis;
  • Rheumatoid arthritis;
  • Lambliasis;
  • Trichomoniasis, amebiasis;
  • Malaria and others.

Among the physical factors, there are also provocateurs of allergic reactions:

  • Increased solar exposure;
  • Heat or cold;
  • Vibration effects.

Prevention

The only preventative measure is to exclude contact with a possible allergen. Therefore, a thorough examination with an allergist is required to determine the causative factor.

Such patients should be careful in their diet and lifestyle in general.

Interesting

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