Quincke's edema: causes of development, symptoms, treatment, first aid
Quincke edema( angio edema), formerly known as angioedema, is one of the forms of inadequate response of the body's immune system to the influence of certain substances-allergens, or physical factors-on it.Usually this disease does not pose a serious threat to life, but it undermines human health.But in some cases, Quincke's edema can be very dangerous.Table of contents: Types of angioedema Reasons for angioedema Symptoms of edema Quincke Diagnosis of edema Quincke Treatment of edema Quincke Non-drug treatment Medication
Types of angioedema
There are several classifications of AO, each of which is based on one criterion.So, along the course of the disease divided into acute( lasting less than 6 weeks) and hronesque( over 6 weeks).By the presence of urticaria during an attack - on a combination( with rashes, itching, etc.) and isolated angio-edema. However, the most complete classification is considered by the mechanism of occurrence:
- hereditary angio-otek associated with genetically conditioned and irregularities in the regulation of the complement system, a complex of substances directly responsible for allergies;
- Acquired angio-edema, in which disorders of regulation of the complementary system are acquired due to immune disorders, infections, lymphoproliferative diseases;
- angio-edema caused by prolonged intake of one of the categories of antihypertensive agents - ACE inhibitors;
- edema caused by hypersensitivity to certain substances - drugs, food, insect poison, etc.;
- edema associated with infections of various organs;
- Quincke edema caused by autoimmune diseases.
The most common are 2 forms of angioedema, hereditary and allergic:
Causes of angioedema
The body is affected by an allergen, and the immune system responds by ejecting large amounts of allergic mediators.Among them the leading role in the development of the disease belongs to histamine.This substance in the case of an allergy is produced in excess, and this leads to the expansion of the capillaries, the escape of the liquid part of the blood and the build-up of the edema.
However, it is possible that histamine is released in normal amounts, but either the cellular receptors react too sharply to it, or the system of its "utilization" - special enzymes - does not work well enough.
In any case, the result is one - the appearance of a symptomatic symptomatic angio-edema.
Symptoms of edema Quincke
The clinical picture of the angioedema of Quincke depends first of all on what factor triggered angioedema.In addition, it is important to understand the exact location of the lesion.
Note: specialists know that far from always swelling occurs on the face and neck.Possible damage to the intestinal mucosa with the appearance of a characteristic picture of the "acute abdomen", and swelling of the meninges with symptoms of meningitis( though without signs of inflammation), and a urinary tract with a delay in urine.
Nevertheless, with angioedema in its pure form, most often manifestations appear on the face, which becomes puffy, eyes swim in this way, lips grow in size.Usually, swollen tissues do not change color, are painless, however, if you squeeze nerves, you may get pain or a feeling of "goose bumps".
If a patient has itchy skin, reddening face and neck, then there is talk of joined urticaria - another allergic disease with a similar development mechanism.
Important: The laryngeal edema is the most formidable manifestation of angioedema and the most dangerous of all its complications.He grows quickly enough and can completely block the voice gap, blocking the possibility of breathing.Emergency help given to the patient in the first few minutes can save his life, procrastination deprives him of his chances of survival.
Diagnosis of Acute Quincke
When making a diagnosis, information about the history is of high importance. The physician should thoroughly understand the following:
- , were there no cases of angioedema or laryngeal edema in the blood relatives of the patient;
- has it suffered from allergies before;
- in women - whether their condition worsened during pregnancy or during oral contraceptive use;
- does the patient not take ACE inhibitors;
- he was hospitalized or his blood relatives in the surgical department with the clinic of the "acute abdomen", which was subsequently not confirmed( meaning repeated hospitalization, single cases do not count);
- are there any concomitant infectious, autoimmune or lymphoproliferative diseases.
After finding out the details of the anamnesis, the patient is prescribed a set of diagnostic measures:
- general blood test;
- study of plasma proteins;
- revealing the level of cryoglobulin, thyroid-stimulating hormone;
- assay for immunoglobulins E to food allergens;
- Ultrasound of the abdominal cavity;
- skin biopsy;
- puncture of the lymph nodes;
- consultation of specialized specialists - urologist, ENT doctor, hematologist, rheumatologist, etc.
Treatment of edema Quincke
In angio-therapy, the first task is to stop an acute attack.On the second place( but by no means significant!) Is the task of preventing the recurrence of the disease.
Not every patient with Quinck's edema is treated in a hospital. Only patients are hospitalized:
- With the threat of death due to edema of the larynx and tongue, capable of causing asphyxiation( asphyxiation) at any time.
- With intestinal edema that can cause dehydration due to loss of ability to absorb water.
- In the absence of the effect of outpatient treatment.
- In case of difficulties experienced by the attending physician in terms of diagnosis.
The medical measures are divided into two types - medicamentous and non-medicinal.
Among these activities, the first place is to ensure the function of breathing.For this, if necessary, the patient may be intubated or he may undergo tracheostomy surgery( a puncture in the anterior wall of the trachea with insertion into the hole of a special tube - tracheostomy).
Patients with serious cardiac and vascular diseases are monitored for consumed and secreted fluid in order to reduce the burden on the heart.
In the same group of activities it is possible to include training the patient in correct behavior:
- of a person learns to recognize the initial signs of an impending attack;
- with slight exacerbation the patient independently observes his state of health by following all the doctor's instructions;
- at the slightest difficulty breathing, changing speech, the appearance of edema of the larynx patient should immediately consult a doctor;
- person is strongly encouraged to constantly carry a "patient's passport with an allergic disease", which indicates all the data relating to his illness, the institution where he is on the account, the address, contacts of close people.
Medications are something that can stop the attack of Quincke's edema and what can prevent a relapse. In this pathology, depending on its form, the following is used:
- aminocaproic or tranexamic acid;
- diuretic - furosemide - with edema of the face and larynx;
- glucocorticoids - dexamethasone, prednisolone - with edema of the face and larynx;
- for the edema of the larynx is also used a solution of adrenaline in the form of inhalation.
With Quincke's edema caused by medication and oral contraceptives, treatment is stopped.
Angioiothecine is a very unpleasant, and in some situations also deadly disease.If a person has arisen at least once in his life, the risk of his recurrence will exist until his last day.Therefore, it is important to avoid contact with known allergens, and at the slightest suspicion of relapse - contact a doctor.
More details of first aid measures for Quincke's edema, the symptoms of this disease and the factors that provoke its development are described in this video review:
Bozbey Gennadiy, medical reviewer, ambulance doctor