Quincke's Edema: Symptoms and Treatment
- Edema Quincke: what is it?
- Causes of Quincke Edema
- Quincke's Edema: symptoms
- Quincke's Edema: help with the first signs
- Diagnosis of Quincke edema
- Treatment of Quincke Edema
- Possible complications with Quinck's swelling
- Quincke edema in children
- Edema Quincke: how not to admit
Angioedema, more commonly known as Quincke's edema, received its popular name in honor of the German physician Heinrich Quincke, who for the first time in 1882 described this dangerous condition. Indeed, in some cases it poses a direct threat to life. That is why it is so important to know what Quincke's edema is, for whom there is a high risk of its onset and what to do if symptoms of the disease appear.
Edema Quincke: what is it?
Quincke's edema is a disease of an allergic nature, which manifests itself through the appearance of pronounced edema of the skin, subcutaneous tissue and mucous epithelium. Usually, the pathology is fixed in the following areas of the body:
- upper part of the trunk;
Much less often the edema develops on the internal organs, joints and even the membranes of the brain.
Angioedema can affect absolutely any person. However, there is a group of people most susceptible to the disease - it's allergies. And much more often than in older people and men, pathology develops in children (except for infants who have such an edema very rarely, although it is possible) and women of young age.
Causes of Quincke Edema
There are two types of Quincke edema - allergic and pseudoallergic. And they are precisely the causes that cause a dangerous condition.
If it is a question of Quincke's allergic swelling, then in this case the "culprit" is a specific allergen, which has entered the body of a person suffering from allergies. Then massive swelling becomes a kind of response to the stimulus. Usually described condition is combined with such diseases and ailments as pollinosis, bronchial asthma, food allergy, urticaria .
In the case of the pseudoallergic edema of Quincke, the cause of the pathology is the congenital defects of the complement system, a group of proteins that take part in the formation of primary immune and allergic reactions. Normally, these proteins remain in tranquility, and are activated only when the allergen enters the body. If there are defects in their structure, the complement system works either spontaneously or in response to thermal, chemical and cold stimuli.
Quincke's Edema: symptoms
Quinck's swelling is not likely to go unnoticed. After all, the very first of them is a rapid and sharp swelling of the skin, subcutaneous tissue and mucous epithelium on the affected area, visible to the naked eye. As a rule, the skin on these areas initially does not change its natural shade, and a little later it pales noticeably.
Quincke is most often localized on the lips, tongue, eyelids, cheeks and larynx (the most dangerous case).
Patients usually do not feel itchy, but they are troubled by pain and burning. Patients at the time of edema experience unpleasant tension, an increase in tonsils, soft palate and tongue.
The greatest danger is the spread of the pathological process to the laryngeal mucosa, as well as to the pharynx and the trachea, which creates obstacles for normal breathing. Meanwhile, this state according to statistics occurs in every fourth, suffering from angioedema. Its signs are hoarseness, noisy labored breathing, shortness of breath, barking cough and, as a result, first a sharp reddening of the skin of the patient, and then their unnatural pallor, expressed anxiety of the patient, even fainting is not excluded. In the absence of urgent professional appropriate care, the patient quickly falls into the hypocapnic coma, after which the risk of death due to lack of oxygen is high.
In the event that the Quincke's edema affects the gastrointestinal tract, its symptoms are severe abdominal pains, as well as vomiting and diarrhea. When the edema develops on the meninges, there are neurological signs: hemiplegia, aphasia, epileptiform seizures, etc.
Quincke's Edema: help with the first signs
Immediately, as soon as there is a suspicion of angioedema, it is necessary to call a doctor. Prior to his arrival, the patient needs to provide first aid, which includes the following activities:
- fencing from contact with the allergen (for example, if it is an insect bite, then the first thing to do is to remove the sting);
- ensuring the supply of clean fresh air to the room where the patient is;
- calming the victim;
- release of the victim from tight clothing, belt, belt, tie;
- removal from the patient's body of an allergen by means of copious seizure of a person and intake of sorbents - the same activated carbon;
- burying in the nose of the affected vasoconstrictor drops, which will only be at hand;
- the imposition of a cold compress on the affected area and preferably harnessing to a place above it - in the event that swelling occurs in response to an injection of a medicine or an insect bite;
- taking the appropriate antihistamine drug.
Emergency help for swelling of Quincke is accompanied by such actions as:
- detoxification therapy: hemo-sorption, enterosorption, etc .;
- hormone therapy (introduction prednisalona intravenously or intramuscularly);
- desensitizing therapy (suprastin administration intramuscularly);
- use of diuretics;
- use of protease inhibitors.
And, of course, the patient in this case needs urgent hospitalization in the department of allergology. Quincke's edema, especially its severe forms - a condition requiring urgent skilled care. Sometimes the account goes literally for a minute.
Diagnosis of Quincke edema
First of all, the doctor conducts an examination in order to familiarize himself with the symptoms present. In addition, the reaction of the edema to adrenaline administration is necessarily taken into account.
The next step is to establish the cause of the pathology. As a rule, it is enough to interview a patient about what allergic diseases are present in his anamnesis or anamnesis of his next of kin, what is his body's reaction to eating various foods, taking medications, contacting animals. Sometimes for the detection of a cause, specific blood tests and allergens are required.
Treatment of Quincke Edema
In case of development of an edema in the pharynx, larynx or trachea, an emergency hospitalization of the victim with subsequent treatment in the conditions of resuscitation or intensive care unit is required.
In general, the treatment of Quincke edema is carried out in several ways.
- Exclusion from the life of the victim of all potentially dangerous allergens. Specific recommendations are given after determining the exact cause of edema. In this case, the patient is encouraged to refuse to eat foods rich in natural salicylates (raspberries, cherries, strawberries, peaches, apples, grapes, strawberries, apricots, plums, tomatoes, carrots, potatoes), as well as use of certain medications such as, for example, Pentalginum, citramone, baralgin, paracetamol, indomethacin, and others.
- Drug therapy. This direction of treatment is the appointment of the treating doctor antihistamines and corticosteroid drugs. In the presence of hypersensitivity to individual foodstuffs, to reduce it, enzyme preparations are used, such as, for example, festal.
- Correction of a way of life. Those who have undergone the edema of Quincke should stop smoking, alcohol abuse, and such patients are advised to avoid stressful situations, overheating and hypothermia.
Possible complications with Quinck's swelling
As mentioned above, the most dangerous complication of Quincke's edema affecting the larynx or trachea is asphyxia leading to coma, and possibly disability or death.
If the edema is localized in the gastrointestinal tract, then complication in the form of peritonitis is possible, as well as an increase in the intestinal peristalsis and dyspeptic disorders can be observed.
In the event of a lesion of the urogenital system, the complication can manifest through the symptoms of acute cystitis and the development of urinary retention.
The greatest anxiety is caused by edema on the face, because if there is a possibility of damage to the brain or its membranes, accompanied by the appearance of labyrinth systems and meningic symptoms - all this poses a direct threat to life.
Quincke edema in children
Quincke's edema in children is a rather common phenomenon. In this case, in such a young patient, the pathological process has its own peculiarities.
First, edema in children can reach quite large sizes. In addition, it is of a migratory nature, that is, it can arise in one place or in another place, as if moving. If you feel the swelling, it will be fairly dense and uniform. When you click on it, a depression does not appear. About 50% of cases of angioedema in children are accompanied by the appearance of urticaria.
Especially dangerous for patients of tender age swelling of the throat and larynx. After all, all the pathological processes in a child develop more rapidly than in an adult, so with the slightest suspicion, it is so important, without losing a second, to urgently call an ambulance.
If Quincke's edema has affected the child's gastrointestinal tract, the patient will most likely be disturbed by abdominal pain, tingling of the tongue and palate, and diarrhea and vomiting that appear later.
Even if the edema develops exclusively on the skin, children may suffer from fever and severe joint pain. In addition, in this case, increased excitement of the child is possible and even a syncope is possible.
Parents of every allergic child should know the most common causes of Quincke's life-threatening edema in children:
- taking certain medications: antibiotics (in particular, penicillin), seizures , acetylsalicylic acid, iodine-containing drugs, B vitamins;
- certain foods that provoke allergy in a particular child, as well as various food additives that may be present in some foods: for example, a number of dangerous preservatives and dyes are found in sausages, exotic fish dishes, juices, cheese, etc.;
- insect bites;
- pollen, which is released during the flowering period of some plants.
Edema Quincke: how not to admit
People who are especially prone to allergic reactions need to follow certain preventive measures that will prevent the development of such a dangerous condition as Quincke's edema.
First, you must always adhere to a strict diet. In this case, allergens should be excluded not only from the diet, but in general from the human environment (in particular, this applies to pets). However, the latter is not always done in the will of a specific allergy sufferer. Therefore, in cases where it is impossible to protect oneself from contact with irritants (for example, during the flowering period of a particular plant), antihistamines should be taken.
Patients suffering from hypersensitivity to insect bites should, in appropriate seasons, not forget about repellents. In addition, they should avoid wearing bright clothes at that time - it attracts mosquitoes, bees and wasps. And, of course, do not go barefoot on the street, even in the summer.
Parents, whose child is prone to allergies, it is necessary not only to restrict their child in every possible way from contact with sensitizers, but also to maintain the ideal purity in the house, so that, as they say, there was not a speck of dust in the corners. In addition, it is important to regularly ventilate the rooms, often spend in them wet cleaning and ensure the optimum level of humidity and temperature in the home.