For most of us, allergic reactions are unpleasant, but not dangerous to life and he alth. However, such a statement will be erroneous in relation to Quincke's edema. What is hidden under this name, we invite you to find out further. Consider also the causes of this reaction, first aid and treatment directions.
What is this?
What is angioedema? This is a pathological, disproportionate reaction of the immune system to some kind of external stimulus. As a result, the body produces histamines and prostaglandins - specific substances that are responsible for the immune response to inflammation. In particular, they help increase the permeability of small vessels (capillaries). Lymph from them begins to flow into the surrounding tissues.
How does Quincke's edema start? Accordingly, with the passage of lymph into the tissues of the organs surrounding the vessels. Such an incorrect reaction of the body to an irritant was known to medicine many centuries ago. But it was scientifically studied not so long ago. The name of the reaction was given by the name of the German physiologist Heinrich Quincke, who described similarpathological cases from observations of his patients at the end of the 19th century. It was he who developed the first effective methods of treating this condition.
Wrong names
You can read about Quincke's edema in ICD 10 - International Classification of Diseases. In addition to the correct, scientific, incorrect descriptions of this state are still used:
- Angioneurotic edema. Not quite an accurate description. The fact is that it was previously believed that such swelling was caused by dysfunction of the nerves that control the constriction and expansion of blood vessels.
- Quincke tumor. Appropriate, but incorrect. Such a name completely contradicts the description of Quincke's edema in ICD 10. This has nothing to do with real tissue tumors. They represent an abnormal growth of cellular tissue, not swelling caused by excessive lymph secretion.
Sometimes this swelling is called giant urticaria. But that's also not the right name. Quincke's edema is still much more dangerous. And it has significant differences. In particular, the patient completely lacks itching, which is so characteristic of urticaria. Another distinguishing feature is the absence of a rash (it happens not only with hives, but also with other allergic reactions).
If you press on the swollen area, it will continue to remain tight - it will not form a hole. Skin color with such swelling does not change, remains the same.
Reaction characteristic
What does Quincke's edema look like, you can find out by looking at the photos in thisarticle. It affects many tissues, including internal organs. But still, most often it can be seen on the external (skin, mucous) tissues of the upper half of the body - the face and neck. It also "selects" locations such as limbs and genitals.
But the most dangerous is the appearance of such reactions on the organs of the respiratory system and the meninges. Here, such complications of Quincke's edema as suffocation and cerebrovascular accident become real. If the necessary medical care is not provided in time, an allergic reaction can be fatal.
But don't think that Quincke's edema is a common form of allergy. According to statistics, these complex cases make up no more than 2% of the total mass of allergic reactions in the body. But such edema is not an example of an exotic disease. The chance of encountering it first hand is quite high. The same medical statistics show that every 10th person in the world has experienced Quincke's edema in a different form of severity.
Development
Allergic reaction Quincke's edema occurs in patients of all ages. However, children and young women are at risk here. Of course, there is a greater risk of experiencing it in people who are generally prone to allergies. But Quincke's edema can also develop in a person who does not belong to risk categories.
It is also impossible to name the average speed of propagation of such a reaction. In some cases, the strongest edema may appear in a few minutes. And in other cases heprogresses over several hours or even several days. It depends both on the type of allergen and on the time of its exposure to the body.
The duration of the period during which the edema does not go away can also be individual. In some cases, it does not go away within a week. If the period is more than 6 weeks, it makes sense to talk about chronic angioedema.
A person is subject to such an allergic reaction, starting from the first days of his life. The causes of Quincke's edema in infants are feeding with artificial mixtures, adding cow's milk to the diet, taking a number of medications.
In the first months of life, the reaction is experienced by the body much harder than in the adult period of life. Therefore, most of the lethal outcomes of the disease, unfortunately, are observed among infants. More importantly, in young children, severe forms of edema are more common, affecting the mucous membranes of the stomach and meninges. In some cases, this allergic reaction is combined with bronchial asthma.
Common causes
As with other types of allergic reactions, angioedema begins, develops as a response to allergens - various substances:
- Elements of various food products: nuts, fruits, milk and egg proteins, chocolate, fish products, honey, a number of food additives - dyes, preservatives, flavor enhancers, etc.
- Medicines, among which antibiotics, B vitamins, bromides, anesthetics, aspirin, iodides, a group of antihypertensive drugs should be highlighted.
- Toxins and poisons (especially insect poisons).
- Animal wool.
- Plant pollen.
- Household chemicals or industrial chemicals - turpentine, phenol, etc.
- Dandruff, dust.
- Various microorganisms - bacteria, fungi, viruses.
Of course, in relation to each patient, the allergen is individual. It can be any substance that is absolutely safe for other people. The fastest and most severe allergic reactions develop, as a rule, in response to insect and snake venoms.
There are also indirect factors contributing to the development of Quincke's edema in severe form. These are a number of diseases of internal organs, endocrine pathologies and helminthic invasions.
Do not forget that there is a risk category - people with a hereditary predisposition to an allergic reaction in the form of Quincke's edema. They can develop it even without visible allergens. For example, during severe stress or in response to hypothermia.
Symptoms
Let's consider how Quincke's edema manifests itself. The reaction starts with:
- Swelling and a significant increase in the size of the soft tissues of the face and neck. In some cases, the patient's face swelled so much that it resembled a ball or a balloon. Instead of eyes, slits may remain. In some cases, the patient is not able to open his eyes at all.
- In some cases, the edema further passes to the hands, affects the areas of the fingers, feet, and appears on the chest. That is, it affects all layers of the skin,including mucous membranes and subcutaneous tissue.
- In rare cases, it can affect the digestive tract and joints. A similar reaction is mainly observed if allergens enter the stomach along with food or they (allergens) are drugs.
- It is impossible not to note such signs as a decrease in pressure, increased work of the sweat glands, tachycardia.
- Conscience may become confused, coordination may be disturbed. The patient may note causeless fear, anxiety and anxiety.
Note that in half of the cases Quincke's edema is additionally accompanied by urticaria. It is expressed as follows:
- Itchy skin.
- Wearing.
- Conjunctivitis.
- The appearance of various sizes of blisters.
Worrying symptoms
We also note specific cases of edema, when the patient needs urgent medical care.
The fact that edema begins to develop in the upper respiratory tract (larynx, trachea, bronchi, mucous membranes of the nasopharynx and pharynx) says the following:
- Severe sore throat.
- Occurrence of "barking" cough.
- Difficulty breathing (especially when inhaling).
- Speech problems.
- Skin first turns red and then turns blue. There may even be some bleeding due to broken capillaries due to pressure.
If the edema passes to the tissues of the organs of the upper respiratory tract, then it is dangerous for the patient to die from asphyxia. The development of Quincke's edema on the mucous membrane of the larynx is typical for 1/4 of the patients.
If on the facegastrointestinal form of edema, the difficulty is that it is easy to confuse it with a disorder of the digestive tract. The patient will complain about the following:
- Sharp pain in the epistragal zone.
- Vomiting.
- Diarrhea.
- Nausea.
- Difficulty urinating.
These symptoms should not be ignored, because only a qualified specialist can make a true diagnosis to the patient. If they are ignored, Quincke's edema can turn into peritonitis, which is dangerous with a fatal outcome.
Another worrying form of edema affects the meninges. The main symptoms here are quite similar to those of meningitis. The following is noted:
- Fear of sound and light.
- Severe headaches.
- Numbness of the occipital muscles (a person cannot press his own chin to his chest).
- Vomiting and nausea.
- Impaired vision and speech.
- Paralysis.
The articular form of edema is not life-threatening. With it, it affects the synovial sections of the joints. This is expressed in a decrease in the mobility of the latter, pain syndrome.
All parents need to know the manifestations of Quincke's edema in young children: for babies, it is dangerous because the child is not yet able to explain what is happening to him. The following signs are considered alarming:
- Blue nasolabial zone.
- General pallor of the skin.
- Difficulty breathing.
- High heart rate.
- Spread of blueness to other areas of the skin.
- Increased perspiration.
- Suffocation followed by loss of consciousness.
- Decrease in heart rate.
First Aid
Every person needs to be familiar with the emergency care algorithm for Quincke's edema. Of course, the first step is to call an ambulance. If this is not possible, try to take the patient to the doctor yourself.
How to treat angioedema? In addition, you can try to help a person yourself by following this instruction:
- Reassure the patient. Do not try to lay him down - he should remain in a sitting position. Pick up a small child.
- If you were able to identify the source of the allergy, then it is necessary to exclude even its slightest effect on the body of the victim. For example, stop taking a medication or food, leave a certain location.
- If the swelling was caused by an animal bite, be sure to remove (if any) its sting. To prevent the poison from spreading throughout the body, a tourniquet is applied to the injured limb (it can be kept for no more than 30 minutes). If this is not possible, a cold compress or ice is applied to the bite site. The same methods are good if the swelling began to develop in response to the injection.
- To ease the breathing of the patient, free him from tight clothing, jewelry. Open a window or take the person out into the fresh air.
- What else can be clinical recommendations for Quincke's edema? If it was caused by food or drugs, then the patient needs to urgentlytake a sorbent (1 tablet per 10 kg of weight) - activated carbon, "Smektu", "Enterosgel". Gastric lavage is prohibited - with swelling of the larynx, the patient may choke on vomit.
- Apply a cold compress to large swelling to promote vasoconstriction.
- Offer the patient unlimited plentiful drink - mineral water, light soda solution.
Medication assistance
Antihistamines for Quincke's edema are the main treatment. The first generation drugs are considered the most effective. "Tavegil", "Diphenhydramine", "Suprastin" with Quincke's edema are extremely effective. Often one tablet is enough to significantly alleviate the patient's condition.
The drug blocks the effects of histamine on special vascular receptors. This counteracts the growth of edema, which is why the person's condition stabilizes. To remove excess fluid from his body, diuretics are used. For the best effect, the tablet is placed to dissolve under the tongue.
If antihistamines helped the patient somewhat, this is not a reason to cancel the ambulance call! Especially in cases where it is not possible to independently identify the allergen.
How to treat angioedema? If there are no antihistamines at hand, refer to the vasoconstrictor drugs used for the common cold - Otrivin, Nazivin, Rhinonorm. Put a few drops into the nasopharynx andlarynx. It is also important to remember that many medications themselves can cause severe angioedema.
Pills will only be effective if the patient does not have swelling of the esophagus or larynx. Otherwise, he simply will not be able to swallow the pill. Therefore, in some cases, the output is only in subcutaneous or intravenous administration of drugs. This care can only be entrusted to qualified medical professionals.
In particular, they can use glucocorticosteroids. The most popular are Dexamethasone and Prednisolone for Quincke's edema. These hormones are able to "turn off" the immune system's response to allergens. How to treat angioedema with their help? As a rule, they are administered intravenously or subcutaneously. If this is not possible, the contents of the ampoule are poured under the patient's tongue.
If such assistance is not provided on time, delay may result in asphyxia and clinical death for the patient. In such cases, you need to turn to artificial respiration.
Inpatient treatment
Ambulance doctors, depending on the severity of the patient's condition, either provide the necessary assistance on the spot or hospitalize him. Patients with fixed laryngeal edema are subject to compulsory admission to the hospital. The following people will also be hospitalized:
- People who first encountered Quincke's edema.
- Children.
- Severe allergic patients.
- Patients with drug-induced edema.
- Patients with severe pathologies of the respiratory and cardiovascular systems.
- Recently vaccinated citizens.
- Patients with recent SARS, stroke, heart attack.
If the patient's condition is stable, he is placed in the allergology department. In severe cases - in intensive care, intensive care unit. Patients are administered antihistamines, diuretics, glucocorticosteroids. With the help of sorbents, they purify the blood of allergens.
How to treat angioedema? They use drugs that have a complex effect on the immune system in combination with a minimum of side effects. These are Ketotifen and Loratadine. For the treatment of infants, "Fenistil" is preferable.
How to protect yourself from angioedema? Be careful with exotic food, do not take drugs (especially for subcutaneous, intravenous administration) without checking them for an allergic reaction of the body. This is especially true for people who are prone to allergies.
It is important to note that you should always have antihistamines on hand in your first aid kit to help relieve this swelling. In addition, you should be aware of the rules for first aid for angioedema. Especially if you have small children.
