Quincke's edema is an acute condition, in which there is a significant swelling of the skin layers and subcutaneous fat, sometimes involving the pathological process of the mucous membranes. The disease was named after the doctor G. Quinke, who first described it in 1882. The second name of pathology is angioedema.
Quincke's Edema - the causes of
Like hives, Quincke's edema is associated with vasodilation and an increase in their permeability to the liquid blood medium, but in this case, puffiness does not appear in the superficial, but in the deep layers of the skin, mucous tissues, subcutaneous fat layer. The accumulation in the tissues of the penetrating interstitial fluid determines edema. Vascular expansion and increase in their permeability is due to the release of biologically active substances (bradykinin, histamine, etc.), which occurs due to an immune response under the influence of certain factors.
The angioedema may be different, and it is often provoked by the following factors:
- action of allergens;
- functional disorders of the digestive system;
- disruption of the endocrine system;
- taking some medications (oral contraceptives, analgesics, antibiotics, ACE inhibitors, vaccines, serums);
- tumor diseases;
- blood diseases;
- viral and parasitic lesions of the body;
- congenital disorders in the body;
- differences in atmospheric pressure, air temperature, etc.
Hereditary edema of Quincke
One of the rare varieties of the pathology under consideration is hereditary angioedema, which is associated with a disorder in the complement system transmitted by inheritance. The complement system, consisting of combining protein structures, is an important component of the immune system, which is involved in inflammatory and allergic reactions. Regulation of this system is due to a number of enzymes, among them - inhibitor C1. When this enzyme is deficient, uncontrolled complement activation and massive release of substances causing edema occur.
The first signs of Quinck's edematous edema can appear even in childhood, but in most cases debut in the puberty period or in middle age. The development of an attack is often preceded by one or another provoking phenomenon:
- infection;
- powerful emotional stress;
- surgery;
- injuries;
- taking any medications.
Allergic Quincke's Edema
Allergies are the most common cause of angioedema. In addition, often the disease is combined with other diseases of an allergic nature - pollinosis, bronchial asthma, urticaria, atopic dermatitis , etc. If the mechanism of appearance of the pathology in question is an allergy, Quincke's edema is a kind of response to the stimulus. As irritant factors can be:
- food products and additives to them (fish, citrus fruits, honey, nuts, chocolate, flavors, colorants, preservatives, etc.);
- pollen ;
- feathers and down of birds;
- animal hair ;
- poison and saliva of insects;
- room dust;
- means of household chemical goods;
- solar radiation;
- high or low temperatures;
- medicines, etc.
Idiopathic Quincke's Edema
There is also an idiopathic angioedema, which can not be explained. In this case, attacks of an inadequate reaction of the organism can not be connected with any specific preceding factors. This form of pathology, many experts call the most dangerous, because, not knowing what provokes swelling, you can not prevent its appearance and eliminate the factor-culprit.
Quincke's Edema - symptoms
Angioedema symptoms are pronounced, which it is difficult not to pay attention to, including because they are capable of causing considerable discomfort and hamper the functioning of certain parts of the body. Edema on the affected area is noticeable with the naked eye, the skin (or mucous membrane) looks swollen, while practically not changing its hue (only later it can noticeably turn white).
Common areas of localization are:
- face;
- oral cavity;
- language;
- larynx;
- trachea;
- neck;
- genitals;
- upper and lower limbs;
- internal organs (stomach, intestine, bladder, meninges, etc.).
In the affected area, patients experience tension, tightness, slight soreness, burning, tingling, rarely - itching. Affected internal organs can cause reactions such as abdominal pain, nausea, vomiting, diarrhea, urine, headache, etc. The affected respiratory tract react with the appearance of shortness of breath, coughing, difficulty breathing, can provoke suffocation. Quincke's allergic edema is often accompanied by the appearance of itchy red rashes. Precipitation of puffiness may be a slight burning and itching.
How quickly develops the edema of Quincke?
In most cases, if an allergic reaction takes part in the development mechanism, Quincke's swelling appears swiftly, beginning suddenly. Symptoms develop within 5-30 minutes, and resolution should be expected after several hours or 2-3 days. With the non-allergic nature of the pathology, puffiness often develops within 2-3 hours and disappears after 2-3 days.
Angioedema of the larynx
Angioedema of the throat presents a serious danger to the body and may even cause a sudden death. In just a few minutes, the airways can be completely blocked due to swollen tissues. Dangerous signs, which should be an urgent reason for calling an ambulance, are:
- blue skin of the face;
- strong wheezing;
- a sharp drop in blood pressure;
- convulsions.
Angioedema of the face
On the face, the edema of Quincke, whose photo shows a marked symptomatology, is often localized in the eyelids, cheeks, nose, lips. At the same time, eye slits can sharply narrow, nasolabial folds can be smoothed, one or both lips may sharply grow in size. Edema can rapidly move to the neck area, affect the airways and block air access. Therefore, the swelling of Quincke on the face should be stopped as soon as possible.
Angioedema of the extremities
The signs of the Quincke's edema, localized on the hands and feet, are often observed on the back of the feet and palms. This type of reaction is less common than described above and does not pose a particular threat to the functioning of the body, although it causes significant discomfort. In addition to the appearance of limited areas of compaction on the limbs, the skin may acquire a bluish tint.
What to do with Quincke's swelling?
Patients who have had an episode of sudden swelling of one or another part of the body at least once in their life should know how to remove the swelling of Quincke, because the pathology can arise again suddenly. First of all, you should call an ambulance, especially when there is swelling in the airway or there is a suspicion of localization of pathology in the internal organs. Prior to the arrival of health workers, first aid measures must be taken.
Edema Quincke - First Aid
Emergency care for Quinck's swelling, which can be provided before the ambulance arrives, includes the following stages:
- Isolation of the victim from the action of the stimulus (if it is installed).
- Providing free access to clean air.
- Release of the patient from crushing clothes and accessories.
- Arrangement of the patient in a semi-sitting or sitting position to facilitate breathing.
- Maintaining a calm environment around, preventing panic.
- Imposition of a cold compress on the lesion site.
- Provide abundant drinking (preferably alkaline).
- Medications: vasoconstrictive drops in the nose (Naphthyzin, Otryvin), antihistamines (Fenistil, Suprastin) and sorbents (Enterosgel, Atoxil) inside.
The above measures, which provide assistance with the swelling of Quincke, are necessary, first of all, when observed:
- swelling of the nose;
- swelling of the lips;
- swelling of the oral mucosa;
- swelling of the throat, larynx;
- swelling of the neck;
- edema of internal organs.
How to treat angioedema?
Emergency medication to eliminate acute edema and restore vital functions may include the use of such drugs:
- Adrenaline - with a decrease in blood pressure;
- Prednisolone, Dexamethasone - in the case of Quinck's edema, the main manifestations are removed;
- Glucose, Haemodez, Reopoliglyukin - to eliminate the shock and toxin elimination;
- Dimedrol, Suprastin injection - with an allergic reaction;
- Furosemide, Mannitol - at normal and elevated pressure to remove excess fluid and allergens;
- Eufillin with Dexamethasone - for the removal of bronchial spasm, etc.
Non-allergic edema Quincke treatment has a different, sometimes carried out through the transfusion of blood plasma and the use of such drugs:
- Z-aminocaproic acid;
- Counter.
Out of acute stage, treatment may include:
- exclusion of established irritants;
- Short courses of hormonal therapy (Prednisolone, Dexazone);
- use of drugs to strengthen the nervous system and reduce vascular permeability (Ascorutin, calcium, vitamin complexes);
- taking antihistamines (Loratadine, Suprastin, Cetirizine).
Quincke's Edema - consequences
Patients who are diagnosed with recurrent angioedema with chronic course should always be ready to avoid complications and carry the necessary drugs to stop the attack. When there is a swelling of Quincke, the symptoms and treatment of which are ignored or inadequate therapy is being performed, this threatens health and life-threatening consequences. Among them:
- anaphylactic shock;
- asphyxia;
- neurological disorders;
- acute cystitis;
- intestinal obstruction;
- peritonitis.