Allergic angioedema symptoms. Quincke's edema - symptoms and treatment, photo

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One of the most pronounced manifestations of allergies is Quincke's edema - this is the body's reaction to biological objects or chemicals that are perceived by the immune system as foreign and dangerous.

Complications can be fatal, so the disease requires urgent medical care. I will talk about the causes of angioedema, symptoms and treatment of the pathology in this publication.

Quincke's edema - what is it?

Quincke's edema is a violent allergic reaction accompanied by swelling of the skin and mucous membranes, in more rare cases - internal organs, meninges or joints. Other names for the disease are angioedema, giant shock.

• Anyone can develop Quincke's edema, but people with one or another type of allergy are at risk.

At the physiological level, such rapid allergic edema occurs due to the release of large amounts of histamine into the blood. This substance is inactive in its normal state, but when an allergen enters the body, it is released, leading to thickening of the blood and the development of severe swelling.

Some episodes of angioedema are due to heredity, or their etiology cannot be determined. The genetic cause is associated with a disruption in the functioning of complements immune system.

This is a complex of proteins that is responsible for the immune response to the invasion of allergens and other foreign objects, pathogenic cells. If the complement system is disrupted, then such proteins begin to spontaneously react even to harmless stimuli, for example, exposure to heat or cold. As a result, a violent allergic reaction occurs.

In most cases, allergic angioedema is associated with a specific allergen:

• food products;
• medicines;
• cosmetics or household chemicals;
• poisons from insect and snake bites;
• dust or pollen;
• pet hair.

The following may accompany edema and increase the risk of its development:

Symptoms of Quincke's edema in adults and children develop within 20-30 minutes after contact with the allergen. At first, the lesion can be localized on the neck, eyelids, lips, then moves to the palate, tongue and tonsils.

Features of edema:

1. Density, no indentation remains after pressing;
2. Painless;
3. The color does not differ from the surrounding mucous membranes and skin;
4. May be combined with urticaria (rash).

Swelling often occurs on the face, neck and respiratory tract, since the nasopharynx and larynx are in most cases the gateway for allergens to enter.

The very first signs of Quincke's edema are as follows:

• tickle in the throat;
• the voice becomes hoarse;
• difficult to swallow and breathe.

A person feels fullness and tension at the site of swelling. The greatest danger is the spread of swelling to Airways- larynx and bronchi - since this is fraught with the development of suffocation.

Other possible manifestations depending on the location of the edema:

• mucous membrane of the stomach and intestines - nausea, vomiting, abdominal pain and diarrhea;
• bladder - problems with urination;
• membranes of the brain - vomiting, dizziness, meningeal syndrome (headache, stiffness of the muscles of the back of the head and neck, pulling the knees towards you and the inability to straighten them).

Quincke's edema in children - features

All parents should be aware of what their child is allergic to and try to avoid exposure to these substances, be it food, pollen or certain medications.

The most dangerous condition is swelling of the larynx. It develops rapidly and the following symptoms appear:

• anxiety;
• shortness of breath, difficulty breathing;
• blue discoloration of limbs and face;
• enlarged neck veins;
• sometimes hemoptysis.

The structure of subcutaneous fat in children differs from that in adults, therefore, with Quincke's edema, the larynx swells faster.

Among the causes of Quincke's edema in childhood The first places are occupied by the following allergens:

• food - eggs, citrus fruits, berries, chocolate, milk, nuts;
• medications - Penicillin, Ampicillin, iodine preparations, Aspirin, B vitamins;
• insect poisons, plant pollen and dust.

If the swelling is not allergic in nature, then it can be triggered by stress, infections, exposure to light or temperature, and toxic substances.

Signs of Quincke's edema in children, which occurs in the mucous membrane of the intestines, stomach and esophagus:

• sharp pain in the abdomen;
• bloody diarrhea;
• repeated vomiting.

First aid for Quincke's edema - 10 steps

Quincke's edema is an emergency condition, and a person's life may depend on the actions of people nearby before the doctor arrives. You need to act especially quickly when localizing allergic reaction in the area of ​​the face, neck, tongue, pharynx.

For Quincke's edema, first aid is as follows:

1. Eliminate contact with the allergen;
2. Remove or unfasten tight clothing;
3. Provide a flow of fresh air;
4. Make a subcutaneous injection of 3% Prednisolone solution at a dosage of 1-2 mg per 1 kg of body weight;
5. Inject intramuscularly an antihistamine - Suprastin solution 2% at the rate of 0.1 ml per year of life (i.e. if the child is 7 years old, then 0.7 ml is administered) or Pipolfen solution 2.5% in the same dose;
6. If there are only tablets (Claritin, Suprastin, Diphenhydramine), then put them under the tongue;
7. Give the patient plenty of water or unsweetened tea and sorbents to remove the allergen from the body (activated carbon, Enterosgel);
8. If swelling develops in the nasopharynx or nose, additionally instill drops with a vasoconstrictor effect (Naphthyzin, Galazolin, Otrivin);
9. If swelling is localized on an arm or leg, be sure to apply a tourniquet above it;
10. When a bee stings, it is important to quickly remove the sting and apply cold to the affected area.

List of drugs, which can be used independently for mild allergic edema:

• Claritin
• Benadryl
• Allertek
• Loratadine
• Zodak
• Clargothyl
• Lorahexal
• Clarisens
• Fenkarol
• Letizen
• Parlazin
• Claridol
• Laurid
• Suprastin
• Clarotadine
• Fenistil
• Cetirinax
• Tavegil.

If you have repeated episodes of allergies - urticaria, angioedema - always carry antihistamines and Prednisolone with you.

Treatment of angioedema in adults and children, drugs

In the treatment of Quincke's edema the following is used:

1. Tranexamic and aminocaproic acid, H1-antihistamines and glucocorticosteroids (GCS) for acute angioedema.
2. Diuretics, long-acting corticosteroids and plasmapheresis in severe conditions.
3. If the above drugs are ineffective, Methotrexate, Cyclosporins, Warfarin are used, and sometimes they resort to injection of Epinephrine.
4. A long course of antihistamines is prescribed if the cause of the swelling is not established and it does not interfere with normal breathing.
5. With rapidly increasing swelling of the larynx and respiratory failure, a tracheostomy may be required - an incision in the trachea and its connection to the external environment using a cannula (special tube).

Chronic angioedema treated with:

• H1-antihistamines 2nd generation - Fenistil, Loratadine, Kestin;
• 1st generation H1-antihistamines for exacerbation of allergies at night and increasing symptoms - Diphenhydramine, Antazoline, Hydroxyzine. Their disadvantage is that they cause drowsiness.

During therapy, it is also important to sanitize all foci of infection, since pathogenic bacteria, when an allergen enters the body, stimulate the release of histamine.

Allergy sufferers must adhere to dietary nutrition, excluding chocolate, alcoholic drinks, red berries and citrus fruits, coffee, hot and spicy foods.

Anaphylactic shock with Quincke's edema may become the next step in the development of an allergic reaction.

This is a dangerous condition accompanied by itching, difficulty breathing, anxiety, loss of consciousness and seizures. In such cases, every minute counts, so help must be provided immediately - Hydrocortisone or Prednisolone must be administered and urgently take the person to the hospital.

Forecast

The disease develops unfavorably if medical care is not provided on time. Possible complications:

• respiratory failure;
• swelling of the membranes of the brain;
• swelling of the mucous membrane of the stomach, esophagus, intestines;
• anaphylactic shock;
• damage to the genitourinary organs.

Any of these conditions can lead to death. Children are in the most dangerous situation, as their swelling spreads very quickly.

With timely assistance, the prognosis is favorable.

is an acute disease characterized by the appearance of clearly limited angioedema of the skin, subcutaneous tissue, and mucous membrane various organs and body systems. The main causative factors are true and false allergies, infectious and autoimmune diseases. Angioedema occurs acutely and resolves within 2-3 days. Therapeutic measures for angioedema include relief of complications (restoration of airway patency), infusion therapy (including C1 inhibitor and aminocaproic acid for hereditary edema), administration of glucocorticoids and antihistamines.

ICD-10

T78.3 Angioedema

General information

angioedema) is an acutely developing local swelling of the skin, subcutaneous tissue, mucous membranes of an allergic or pseudo-allergic nature, most often occurring on the face (lips, eyelids, cheek, tongue), less often on the mucous membranes (respiratory tract, gastrointestinal tract, genitourinary organs). With the development of Quincke's edema in the area of ​​the tongue and larynx, the patency of the airways may be impaired, and there is a threat of asphyxia. In 25% of patients, a hereditary form is diagnosed, in 30% - acquired; in other cases, the causative factor cannot be identified. According to statistics, during life, angioedema occurs in approximately 20% of the population, and in 50% of cases angioedema is combined with urticaria.

Causes

Acquired angioedema often develops in response to the penetration of an allergen into the body - a medication, a food product, as well as insect bites and stings. The resulting acute allergic reaction with the release of inflammatory mediators increases the permeability of blood vessels located in the subcutaneous fat and submucosal layer, and leads to the appearance of local or widespread tissue swelling on the face and other places in the body. Quincke's edema can also develop with pseudoallergy, when hypersensitivity to certain medications, foods and food additives develops in the absence of an immunological stage.

Another causative factor contributing to the occurrence of edema is the intake of such medicines, as ACE inhibitors (captopril, enalapril), as well as angiotensin II receptor antagonists (valsartan, eprosartan). In this case, angioedema is observed mainly in elderly people. The mechanism for the occurrence of edema when using these drugs is due to the blockade of the angiotensin-converting enzyme, as a result of which the vasoconstrictor effect of the hormone angiotensin II is reduced and the destruction of the vasodilator bradykinin is slowed down.

Quincke's edema can also develop with congenital (hereditary) or acquired deficiency of the C1 inhibitor, which regulates the activity of the complement system, blood coagulation and fibrinolysis, and the kallikrein-kinin system. In this case, a deficiency of the C1 inhibitor occurs both with its insufficient formation and with increased use and insufficient activity of this component. With hereditary edema, as a result of gene mutations, the structure and function of the C1 inhibitor is disrupted, excessive activation of complement and Hageman factor occurs, and as a result, increased formation of bradykinin and C2-kinin, which increase vascular permeability and lead to the formation of angioedema. Acquired angioedema, caused by a deficiency of the C1 inhibitor, develops with its accelerated consumption or destruction (production of autoantibodies) in malignant neoplasms lymphatic system, autoimmune processes, some infections.

Sometimes there is a variant of hereditary angioedema with normal level C1 inhibitor, for example, with a familial mutation of the Hageman factor gene, as well as in women, when increased production of bradykinin and its delayed destruction is due to inhibition of ACE activity by estrogens. Often, various causative factors are combined with each other.

Classification

According to clinical manifestations, an acute course of angioedema is distinguished, lasting less than 1.5 months, and a chronic course, when pathological process lasts 1.5-3 months or longer. Angioedema is isolated and combined with urticaria.

Depending on the mechanism of development of edema, diseases caused by dysregulation of the complement system are distinguished: hereditary (there is an absolute or relative deficiency of the C1 inhibitor, as well as its normal concentration), acquired (with a deficiency of the inhibitor), as well as angioedema that develops with the use of ACE inhibitors, due to allergies or pseudo-allergies, against the background of autoimmune and infectious diseases. Idiopathic angioedema is also distinguished when it is not possible to identify the specific cause of angioedema.

Symptoms of Quincke's edema

Angioedema usually develops acutely within 2-5 minutes; less commonly, angioedema can develop gradually with an increase in symptoms over several hours. Typical localization sites are areas of the body where there is loose tissue: in the eyelids, cheeks, lips, on the mucous membrane of the oral cavity, on the tongue, and also on the scrotum in men. If swelling develops in the larynx, hoarseness appears, speech is impaired, and wheezing stridor breathing occurs. Development in the submucosal layer of the digestive tract leads to a picture of acute intestinal obstruction - the appearance severe pain in the abdominal area, nausea, vomiting, stool disorders. Quincke's edema with damage to the mucous membrane is much less common Bladder and urethra (urinary retention, pain when urinating), pleura (chest pain, shortness of breath, general weakness), brain (symptoms of transient cerebrovascular accident), muscles and joints.

Angioedema with allergic and pseudoallergic etiology in half of the cases is accompanied by urticaria with itchy skin, blisters, and can also be combined with reactions from other organs (nasal cavity, bronchopulmonary system, gastrointestinal tract), complicated by the development of anaphylactic shock.

Hereditary edema associated with disruption of the complement system, as a rule, occurs before the age of 20 years, is manifested by the slow development of symptoms of the disease and their increase during the day and gradual reverse development within 3-5 days, frequent damage to the mucous membrane of internal organs (abdominal syndrome, laryngeal edema). Angioedema due to hereditary disorders tends to recur, repeating from several times a year to 3-4 times a week under the influence of a variety of provoking factors - mechanical damage to the skin (mucous membrane), colds, stress, alcohol intake, estrogens, ACE inhibitors, etc.

Diagnostics

The characteristic clinical picture, typical of Quincke's edema localized on the face and other open areas of the body, allows you to quickly establish the correct diagnosis. The situation is more difficult when a picture of “acute abdomen” or transient ischemic attack appears, when it is necessary to differentiate the observed symptoms with a number of diseases of the internal organs and nervous system. It is even more difficult to distinguish between hereditary and acquired angioedema and to identify the specific causative factor that caused its development.

Careful collection of anamnestic information makes it possible to determine a hereditary predisposition in terms of allergic diseases, as well as the presence of cases of Quincke's edema in the patient's relatives without identifying any allergies in them. It is also worth asking about cases of death of relatives from suffocation or frequent visits to surgeons due to attacks of repeated severe abdominal pain without any surgical interventions. It is also necessary to find out whether the patient himself had any autoimmune or cancer whether he is taking ACE inhibitors, angiotensin II receptor blockers, estrogens.

Analysis of complaints and examination data often makes it possible to roughly distinguish between hereditary and acquired Quincke's edema. Thus, hereditary angioedema is characterized by slowly growing and long-lasting edema, often affecting the mucous membrane of the larynx and digestive tract. Symptoms often appear after minor trauma in young people in the absence of any connection with allergens, and antihistamines and glucocorticoids are ineffective. In this case, there are no other manifestations of allergies (urticaria, bronchial asthma), which is typical for edema of allergic etiology.

Laboratory diagnostics for angioedema of a non-allergic nature allows us to identify a decrease in the level and activity of the C1 inhibitor, autoimmune pathology and lymphoproliferative diseases. With angioedema associated with allergies, blood eosinophilia, increased levels of total IgE, and positive skin tests are detected.

In the presence of stridor breathing and swelling of the larynx, laryngoscopy may be required; in the case of abdominal syndrome, a careful examination by a surgeon and the necessary instrumental studies, including endoscopic (laparoscopy, colonoscopy). Differential diagnosis of Quincke's edema is carried out with other edema caused by hypothyroidism, compression syndrome of the superior vena cava, pathology of the liver, kidneys, and dermatomyositis.

Treatment of Quincke's edema

First of all, with angioedema of any etiology, it is necessary to eliminate the threat to life. To do this, it is important to restore the patency of the airway, including through tracheal intubation or conicotomy. For allergic angioedema, glucocorticoids and antihistamines are administered, contact with a potential allergen is eliminated, infusion therapy and enterosorption are performed.

For angioedema of hereditary origin in the acute period, it is recommended to administer a C1 inhibitor (if available), fresh frozen native plasma, antifibrinolytic medicines(aminocaproic or tranexamic acid), androgens (danazol, stanozol or methyltestosterone), and for angioedema in the face and neck - glucocorticoids, furosemide. After the condition improves and remission is achieved, treatment with androgens or antifibrinolytics is continued. The use of androgens is contraindicated in childhood, in women during pregnancy and breastfeeding, as well as in men with malignant prostate tumors. In these cases, an oral solution of aminocaproic (or tranexamic) acid is used in individually selected doses.

For patients with hereditary angioedema, before undergoing dental procedures or surgical interventions, as a short-term prophylaxis, it is recommended to take tranexamic acid two days before surgery or androgens (in the absence of contraindications) six days before the surgical procedure. Immediately before invasive intervention, it is recommended to perform an infusion of native plasma or aminocaproic acid.

Forecast and prevention

The outcome of Quincke's edema depends on the severity of the manifestations and the timeliness of treatment measures. So swelling of the larynx in the absence emergency care ends in death. Recurrent urticaria, combined with angioedema and lasting for six months or more, is observed in 40% of patients for another 10 years, and in 50% long-term remission can occur even without maintenance treatment. Hereditary angioedema periodically recurs throughout life. Properly selected supportive treatment avoids complications and significantly improves the quality of life of patients with Quincke's edema.

In case of allergic genesis of the disease, it is important to follow a hypoallergenic diet and avoid taking potentially dangerous medications. In case of hereditary angioedema, it is necessary to avoid injuries, viral infections, stressful situations, taking ACE inhibitors, and estrogen-containing drugs.

Quincke's edema (angioedema) is a sudden and non-painful swelling of deep areas of the skin or mucous membranes. This is an allergic reaction manifested by an increase in the size of the face, neck, arms and legs in people of any age. A dangerous consequence is the death of the patient.

Characteristics of the pathology

The disease was introduced and studied in 1882 by the German scientist Heinrich Quincke. Many situations are associated with the use of ACE inhibitor medications, such as Captopril and Enalapril. Pathology occurs in loose tissue located in the area of ​​the larynx and tongue.

The disease is dangerous as it suddenly affects the upper part of the body and lasts from a few minutes to a couple of hours. Angioedema can occur in anyone and at any age. At risk are allergy sufferers and people sensitive to certain components and substances. It is necessary to exclude foods such as fish, squid, red fruits and vegetables, chicken and milk protein, and chocolate. Unfavorable environmental conditions provoke the development of new episodes.

Main causes and varieties

Edema in children reaches large sizes and quickly occurs in various parts of the body. On palpation, the enlarged area seems dense and homogeneous, and when pressed, no depression appears. In 50% of cases, the child’s body is covered with a small rash. A swollen condition of the larynx and throat is extremely dangerous. Parents should know what causes Quincke's edema. This applies to children who are often exposed to allergic reactions and related complications.

The pathological process forms in the subcutaneous tissue and mucous membranes against the background of an increase in the size of blood vessels (venules) and transcapillary blood exchange. A special fluid accumulates in the tissues, causing swelling. The expansion and increase in the permeability of the vascular wall occurs as a result of the release of biologically active elements. The nature of Quincke syndrome and urticaria is similar, only in the latter case the vessels dilate in the upper layers of the skin.

There are two types of angioedema: allergic and pseudo-allergic. They differ in the reasons that cause dangerous pathology. In the first option, an irritant enters the blood, provoking a specific state of the body in response. Swelling appears due to previous urticaria, asthma, hay fever or food allergies.

The pseudoallergic type occurs against the background of congenital disorders of the immune system. The irritant is heat, cold or a chemical reagent.

Causes of pathology:

Angiotensin converting enzyme (ACE) inhibitors are used to control blood pressure. Edema associated with the use of this group of drugs occurs due to a decrease in the level of the enzyme angiotensin II, leading to an increase in bradykin and the occurrence of edema. After the first dose, the main symptoms of the disease appear.

Types of Quincke syndrome:

• Hereditary. Pathological conditions of swelling are repeated in any part of the body without rashes, appear in relatives and begin in childhood.
• Acquired. Develops in people over 20 years of age without urticaria. The family may not show symptoms of the disease.
• Allergic. Develops together with rashes and itching due to interaction with an irritant.

In 25% of cases, edema affects the larynx, trachea and bronchi. This is a very dangerous condition that requires urgent medical attention because there is a high risk of suffocation or anaphylactic shock.

Forms of the disease:

• Chronic.
• Acute.
• Recurrent.
• Allergic.
• Non-allergic.

Most often, small children and young women suffer from the pathology. Babies are exposed to Quincke's edema with infancy due to an allergic reaction to a new product, medicine, animal or infection.

A pregnant woman becomes sensitive to any influences, so there is an allergic danger. The presence of one episode of the disease indicates the development of Quincke's edema in the unborn child.

When angioedema affects the stomach or intestines, the patient experiences pain in the abdominal cavity, tingling of the tongue, tonsils, diarrhea and vomiting occur. With external manifestations of the disease, children suffer from fever and joint pain. Nervous excitement may occur and fainting may occur.

Typical Symptoms

The characteristics of the symptoms depend on the type of edema. Quincke syndrome begins quickly, within 3-60 minutes various parts of the body enlarge, and the patient’s changed appearance becomes noticeable.

The patient feels tingling, burning and redness in the area of ​​swelling.

When the eyelids become swollen, the eyes close completely. The pathology does not cause pain or itching, but skin tension occurs. With slight swelling of the tissues of the child’s body, the general state, the temperature rises and the child may lose consciousness. You need to be attentive to infants, because they are not able to talk about the signs and complain about being unwell.

Manifestations of edema:

A serious condition is angioedema of the throat and tongue. The process of swallowing saliva is disrupted, causing dryness, cough, hoarseness and changes in breathing. A person can suffocate and die within minutes. With swelling of the lungs, discomfort in the sternum is observed due to fluid entering the pleural cavity. Intestinal syndrome accompanied by vomiting, pain in the epigastric area and diarrhea. Angioedema of the bladder is characterized by a delay in the outflow of urine. If the syndrome affects parts of the brain and its membranes, headache, seizures and changes in consciousness appear.

Symptoms after taking medications do not occur immediately, but during the first week of therapy. Signs of mumps () are similar to Quincke's syndrome, the ear glands also swell, and the patient's face changes in appearance.

Associated complications

The disease can be prevented only by eliminating contact with the irritant. A dangerous consequence is suffocation, which can lead to coma and death of the patient. If swelling of the stomach or intestines occurs, the risk of dyspeptic disorders is high. With lesions of the urogenital tract, acute cystitis and urinary retention develop.

Facial swelling poses a serious threat, as there is a risk of damage to the brain and accompanying membranes. The patient feels strong headache, nausea and vomiting. In the absence of medical care, a person quickly falls into a coma or dies due to lack of oxygen.

At the first signs of swelling, it is necessary to call the suspected irritant ambulance. This will protect against complications, serious consequences and save lives. The disease can recur suddenly at any time.

Diagnosis and treatment

Clinical picture for edema located on the face and other parts of the body allows you to establish the correct diagnosis. The situation is more complicated when signs appear acute pain in the abdomen or when it is necessary to separate symptoms from diseases of the organs and nervous system.

It is difficult to distinguish between congenital and acquired angioedema and to determine the tendency to allergic reactions. The doctor must find out the hereditary predisposition to allergies, the presence of cases of edema in the patient’s relatives. Examinations are prescribed: electrocardiogram, ultrasound and x-ray diagnostics of the digestive organs and chest. A carefully collected anamnesis will prevent relapses and complications. Placing the patient in a hospital will speed up recovery and reduce the risk of negative consequences.

Urgent Care

Based on the description of complaints and examination data, the patient is divided into hereditary and acquired types of the disease. Genetic angioedema is characterized by mildly manifested and long-lasting swelling that affects the throat and stomach. Symptoms occur after injury in the absence of contact with allergens. No other manifestations of allergies are noted.

Diagnosis of non-allergic types of edema in the laboratory reveals a decrease in the amount and activity of the C1 inhibitor and autoimmune pathology. With allergic edema, an increase in eosinophils in the blood is detected, growth IgE level, positive skin tests.

In case of wheezing and noisy breathing during laryngeal edema, laryngoscopy is required; in case of abdominal syndrome, a precise examination by a surgeon and the appointment of studies (laparoscopy, colonoscopy).

Before medical help arrives, it is necessary to perform basic life-saving procedures. Check the patient's breathing and free the chest and neck area, open the windows to ventilate the room. If the patient has been bitten by an insect, the sting is removed from the wound and the patient is given plenty of fluids with a sufficient amount of enterosorbents. An antihistamine should be given.

Check your pulse and measure your blood pressure. A cardiac massage is performed and medications are administered intramuscularly, intravenously or orally.

At home, you can administer Aminocaproic acid orally at a dosage of 7-10 g per day. If possible, a 100-200 ml dropper is placed. Allergic activity and the ability of blood to pass through the vessels into the tissue are reduced. Androgens are also taken or given intramuscularly. They are represented by drugs: Danazol, Stanozol and Methyltestosterone.

Daily dosage of male hormones:

• Danazol - no more than 800 mg.
• Stanazolol - up to 5 mg of the drug.
• Methyltestosterone - 10−25 mg sublingually.

Medicines improve the production of C1 inhibitor. There is a list of contraindications, which includes pregnancy and lactation, childhood, and prostate cancer. Aminocaproic acid is administered to children.

Necessary medications:

Arriving medical workers examine the patient and determine the causes of the disease. It is enough to ask the patient about existing allergic reactions and pathologies, food consumed, medications taken, and contact with animals. Sometimes it is necessary to undergo analysis and allergy tests.

When the throat becomes swollen, the airways may close. To save life, a puncture or incision is made in the cricothyroid ligament and a tube is inserted to provide oxygen to the lungs.

Treatment method for Quincke's edema in non-allergic and allergic type different. The first type reacts poorly to the main medications (adrenaline, antihistamines, glucocorticoids) used to treat acute manifestations of allergies. The effectiveness of antihistamines is due to the suppression of histamine synthesis and its interaction with receptors. They also relieve inflammation.

Medicines are administered in the prescribed manner, first adrenaline is given, then androgens and antiallergic medications. If the clinical reaction is weak, the administration of hormones and antihistamines is sufficient.

At the first sign of illness, adrenaline is injected into the muscle of the outer buttock. This ensures the rapid action of the substance. In serious situations, when swelling appears in the neck or tongue, an injection is made into the trachea or under the tongue. In the best case, the drug is placed into a vein. It reduces the release of histamine and bradykinin, increases blood pressure, relieves bronchospasm and improves myocardial activity.

Adrenaline dosage:

• Adults - 0.5 ml of 0.1% solution.
• Children's age - From 0.01 mg per 1 kg of weight (0.1−0.3 ml of 0.1% product). If there is no improvement in the patient's condition, the administration is repeated.

Hormonal medications include Dexamethasone, Prednisolone and Hydrocortisone. Before help arrives, the medicine is injected into the buttock. The maximum effect is achieved when intravenous administration. If there is no syringe at hand, the ampoule is poured under the tongue. There are veins in this area that allow the medicine to be immediately absorbed.

Dosage of hormonal agents:

• Dexamethasone. You need to take from 8-32 mg. One ampoule contains 4 mg, and one tablet contains 0.5 mg.
• Prednisolone. The dosage ranges from 60−150 mg. The bottle contains 30 mg, and the tablet contains 5 mg of the substance.

Injection into a vein or muscle will speed up the absorption of the medicine, and the therapeutic effect will occur faster. The products relieve inflammation, swelling, and itching. Among antihistamines, drugs that block H1 receptors are used (Diphenhydramine, Loratadine, Telfast, Suprastin, Cetirizine, Zyrtec, Zodak, Clemastine, Diazolin). The antiallergic effect increases with the combination of H1 and H2 histamine blockers: Famotidine and Ranitidine. Medicines are injected into the muscle or taken in tablet form.

Antihistamine dosage:

Antihistamine medications eliminate Quincke's symptoms such as tissue swelling, itching, redness and burning. Inpatient monitoring is required at the discretion of the physician. The medical professional determines the severity of the patient's condition.

Mandatory hospitalization

Specialists who arrive at the scene determine the causes and type of swelling. Depending on the complexity of the disease and external manifestations, the patient is taken to a specialized department. For example, with severe anaphylaxis, the patient is sent to intensive care, and with swelling of the throat - to otolaryngology. If edema is of moderate severity, the patient is treated in allergology or therapy.

Indications for inpatient treatment:

In the hospital, 300 ml of fresh frozen plasma containing the required amount of C1 inhibitor is injected by drip. But in some situations, its use aggravates Quincke's syndrome.

Directions for treating edema:

• Exclusion of all allergens from the patient’s life (berries, fruits, vegetables, Pentalgin, Baralgin, Citramon, Indomethacin and Paracetamol).
• Medical therapy. Doctor prescribes antihistamines and corticosteroids. Sometimes treatment is supplemented with enzyme agents such as Festal.

Changing lifestyle and living conditions. Persons who have suffered from Quincke syndrome need to give up nicotine, alcohol abuse, and are also advised to avoid stress, overheating and hypothermia. In the living area, it is necessary to do regular cleaning and wash bed linen at a temperature of 60 degrees.

If a person experiences a repeated episode of Quincke's edema, he needs to keep a syringe with adrenaline solution in his pocket. Timely and adequate treatment will save the patient’s life.

Prevention measures

If swelling is caused by allergens, it is necessary to exclude any contact with them and maintain a diet. Patients who have a family history of angioedema should use Captopril and Enalapril, as well as Valsartan and Eprosartan, with special care. The drugs can be easily replaced with drugs from another group.

Persons with hereditary edema should avoid injury and surgery. To prevent angioedema associated with the reduction of C1 inhibitors, drugs containing androgens are chosen.

Persons sensitive to insect bites should use protective equipment. Parents whose children are prone to allergies need to limit contact with insects and also keep the apartment clean. It is important to regularly ventilate the room, carry out wet cleaning and ensure an optimal level of cleanliness.

The outcome of the disease depends on the severity of symptoms and timeliness medical procedures. Laryngeal edema in the absence emergency assistance may result in the death of the patient. Recurrent urticaria accompanied by swelling for 5 months or more can last up to 12 years. Half of the patients experience long-term remission without concomitant treatment.

Genetically located angioedema recurs for decades. Precisely chosen therapy avoids complications and normalizes the patient’s quality of life. The outcome of the disease is favorable in most cases, because manifestations are limited to external changes in soft tissue. Angioedema can be controlled. Relapse occurs at any time, so the cause of the manifestation must be established immediately. At the first signs, medical help is required.

An allergic reaction such as Quincke's edema is characterized by rapid development. The first symptoms of the disease appear just a few minutes after human cells come into contact with the antigen. Delayed treatment of the syndrome can lead to serious consequences, to avoid which you should read the following material.

What is Quincke's edema

The impact of certain chemical and biological factors on the body can trigger the development of allergies. In this case, Quincke's edema, or angioedema, is considered the most dangerous manifestation of the immune response. The reason for this is the high risk of damage to the brain and larynx. Experts, answering the question, Quincke's edema - what it is, as a rule, try to give a comprehensive answer. As a result, the patient receives very voluminous information with a great variety of complex medical terms. Meanwhile, the reader can familiarize himself with a simpler explanation of this phenomenon below.

Thus, Quincke syndrome occurs due to contact of a sensitized (sensitive) organism with an allergen. In this case, edema develops due to increased vascular permeability, which is accompanied by the release of a large amount of fluid into the intercellular space. Actually, this is what causes the increase in different parts of the patient’s body.

The first symptoms of Quincke's edema

Signs of an imminent allergy are considered to be swelling of the mucous epithelium and tingling in any part of the body. At the same time, touching on the topic “Angioedema - symptoms,” experts stipulate that each type of this disease is characterized by some special features. Given this fact, doctors, in addition to the allergic nature of the disease, also distinguish between hereditary and acquired reactions to biological or chemical factors. Depending on whether a person has a certain type of disease, signs of angioedema may be as follows:

Clinical picture (diagnostic options)	Type of edema
	Allergic	Hereditary/Acquired
Onset of reaction and its duration	Develops in 5-20 minutes. It goes away in a few days.	Occurs within 2-3 hours. Disappears in a few days.
Localization	For the most part, swelling affects the area of ​​the neck, face, limbs, and genitals.	Develops in any part of the body.
Characteristics of edema	Pale or slightly red dense swelling that does not form a pit after pressure.	Pale tense swelling, after pressing on which there is no pit left.
Peculiarities	Accompanied by urticaria and itching.	Not accompanied by urticaria.

Symptoms and treatment in children

Today, the number of young patients hospitalized due to severe allergic reactions significantly exceeds the number of adult patients. This fact is due to the poor environmental situation and the modern views of parents who advocate early weaning of the child and the use of all kinds of chemical-based baby hygiene products.

Quincke's edema in children, as a rule, is manifested by swelling of the face, lips, genitals, feet and is not accompanied by urticaria. by the most dangerous consequence Allergy is the spread of the syndrome to the larynx area. At the same time, the child has difficulty speaking and has a sore throat. Subsequent rapid progression of edema can lead to the most severe conditions requiring emergency medical care. Less serious manifestations of the disease can be treated at home by using antihistamines in the form of injections or tablets.

In adults

Character clinical manifestations The disease does not depend on the age of the person suffering from allergies. Adult patients experience symptoms completely identical to the symptoms of the disease in children. Meanwhile, it should be noted that in each specific medical history the syndrome develops due to different reasons, which are identified through laboratory research. In addition, developing the theme “ Allergic edema Quincke’s symptoms in adults”, it is important to say that the capable part of the population often experiences symptoms of abdominal syndrome:

• uncontrollable vomiting;
• sharp pain in a stomach;
• diarrhea.

Treatment of Quincke's edema in adults is somewhat different from the therapeutic measures used for the development of the disease in children. The difference lies in the use of medications with greater frequency and dosage. In a situation where the swelling progresses, you should call an ambulance. Before the specialists arrive, you need to inject the person with Prednisolone or Dexamethasone and put an antihistamine under his tongue.

How to treat Quincke's edema

From a medical point of view, it is somewhat absurd to believe that this disease can be dealt with without the intervention of specialists. However, the frequency of the search query “Treatment, angioedema” proves the opposite. The population relies more on their own brains than on doctors. As a result, it must be said that in severe cases of allergies (when the throat swells), it is vitally important for a person to receive medical care in a timely manner. Ignoring this fact is fraught with serious consequences. In general, therapy for angioedema may be accompanied by:

1. The use of medications in the form of antihistamines, hormonal drugs, diuretics, vitamins.
2. Using folk remedies;
3. Surgical intervention– tracheostomy.

First aid for Quincke's edema

As a rule, allergy sufferers have a clear idea of ​​how to relieve the syndrome. Self-help or mutual assistance for angioedema involves taking antihistamines. If there is progress in the pathology, the patient must be taken to the nearest medical facility from home. Besides, in medical reference books There are entire sections devoted to the topic “Quincke’s edema - emergency care.” However, only an ambulance or hospital staff can perform such a complex algorithm of actions. You can find out what other actions you should take before the doctors arrive:

1. Interrupt contact with the allergen.
2. Free the patient's chest and neck from constricting clothing and jewelry.
3. In the absence of antihistamines, you need to pour 2-3 drops of Naphthyzin into the mouth of an adult or child.
4. Perform artificial respiration on the patient if he has lost consciousness.

Treatment at home

In a situation where the allergy has affected a small area of ​​the body remote from the head, you can try to relieve the syndrome in your own home. Experts, answering the question of how to relieve angioedema at home, advise patients to take a warm bath with kelp infusion at the first manifestations of the disease. Due to the beneficial effects of this algae on skin receptors, swelling disappears within a couple of hours. At the same time, in order to prevent exacerbation of the pathology, patients are recommended to adhere to a special diet that excludes the main allergens from the diet.

Folk remedies

The experience of the older generation has more than once helped to cope with the most severe illnesses. Traditional medicines in the section “Quincke's edema, help” contain a large number of recipes with which you can quickly relieve the syndrome. However, before using any product, it is imperative to check its components for allergenicity. Among the most effective folk methods elimination of Quincke's edema can be distinguished:

1. Milk with soda. A well-known remedy for sore throat can also be used to relieve allergy symptoms. Add ¼ tsp to a glass of warm milk. soda. It is recommended to drink this healthy drink throughout the day. Continue treatment until the swelling subsides and the patient looks better.
2. Nettle infusion. 100 grams of dry herb should be poured with a glass of boiling water and left under the lid in a dark place for 2 hours. The finished product must be filtered. The infusion should be consumed ½ glass three times a day until the swelling completely disappears.

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Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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Quincke's edema - symptoms and treatment at home

A person with allergies is a common thing in the 21st century. Literally 200-300 years ago, humanity could not understand what an allergic reaction is and how it occurs. Scientists believe that the development of the disease is directly related to environmental pollution. The allergen is different in each case. Possible diseases of this nature include Quincke's edema.

Quincke syndrome is not as terrible as in past times, since a lot of expensive and cheap medicines for this disease have long been on the shelves of pharmacies. This article discusses the effectiveness of popular drugs that fight angioedema. Medicines and treatment for Quincke's edema are prescribed by a doctor.

When angioedema, called Quincke's syndrome, occurs, medications and drugs are prescribed in stages:

1. First, the reason that caused the pathology is determined. Basically, the reason lies in an allergy to an irritant from the environment.
2. Next, a medicine is prescribed that relieves swelling and bulge in the problem area.
3. The main help for edema is to reduce the histamine released into the patient’s blood.

The main groups of drugs prescribed for allergic rhinitis or other symptoms of an allergic reaction:

• drugs with antihistamines, when taken, reduce the body’s sensitivity to irritants - Suprastin, Diphenhydramine, Diazolin;
• hormonal medications suppress the reactions of the immune system, sometimes administered intramuscularly - Prednisolone and Dexazone.

As an additional remedy, the attending physician prescribes Ascorutin to reduce the permeability of blood vessels. You should not self-medicate, especially for people with diseases of the stomach and other digestive organs, as unauthorized prescription of medications will worsen the condition.

Drugs for the treatment of Quincke's edema

When any part of the body swells and there are signs of angioedema, you should immediately consult a doctor. After diagnosis, therapeutic therapy is carried out, including the drugs described below.

Antihistamines

Antihistamines and medications for angioedema are necessary to reduce the amount of histamine in the blood, which appears due to the immune response to an allergen from the external environment. The main role in treatment is to alleviate manifest allergies, reduce swelling of the mucous membrane, prevent a decrease in blood pressure and have a soporific effect.

Angioedema in children and adults is treated with a well-known medicine - Suprastin. After taking it, the patient feels better due to the substance described above being reduced in the blood. The main task is to block histamine receptors and prevent the appearance of symptoms of an allergic reaction.

Usually the doctor prescribes complex therapy together with an antihistamine in order to relieve the patient from the negative effects of edema as quickly as possible. Suprastin is used in the form of injections for the treatment of Quincke syndrome. The allergy is eliminated 25 minutes after taking the product. The medicine works within 24 hours.

Hormonal

A particularly difficult case is when antihistamine therapy does not bring the desired effect. Then, for Quincke's edema, Prednisolone or Dexamethasone is prescribed. The full course consists of taking 50 mg active substance per day.

The main properties of the drug are the elimination of shock and allergies. When a sick person takes medicine, adrenaline enters the blood. That's why blood vessels narrow and blood pressure rises.

Hormonal anti-edema agents suppress the immune response to an allergen that the body cannot tolerate, as a result of which cell destruction stops. The irritant does not enter the body, and the swollen area is restored.

Prednisolone is injected once into the veins or muscles. Then a course of medical therapy is prescribed - tablets are prescribed to be taken 4 times a day. General treatment The drug is indicated for no more than 10 days.

Prednisolone is a strong medicine that acts instantly for Quincke's edema. Therefore, you should follow the instructions for use and set the dosage correctly.

Other drugs

If the swelling did not appear due to an allergic reaction, or the anti-allergic Suprastin did not help, the doctor prescribes special tablets for Quincke syndrome, the role of which is to reduce the content of the C1 inhibitor.

• Concentrated C1 inhibitor - administered intravenously. Use with caution, as it can increase allergies, especially in people with damage to the gastric mucosa.
• Aminocaproic acid - used independently before the doctor arrives. Take 10 mg per day. Used as an antiallergenic agent to lower blood pressure.
• Androgens or male hormones. The most famous of this series are Stanazol and Danazol.

The drugs listed above are strictly contraindicated in pregnant women until the birth of a child and breastfeeding. Absolutely should not be given to children.

Medicines for children

The development of an allergic reaction in childhood is treated with an antihistamine with the correct dosage. As a rule, angioedema in this case develops rapidly and may be accompanied by increased sensitivity to food. To suppress the effect of the allergen in the child’s body, medications with enzymes are prescribed - Creon and Festal.

What can pregnant women do?

If a woman is pregnant and has angioedema, it is worth excluding from medications those that pose a threat to the unborn child. At self-treatment Dangerous complications may arise.

Most best options for pregnant women - taking Zyrtec and Claritin. To reduce vascular permeability, calcium gluconate is often prescribed in the form of tablets and injections into a vein. In some cases, a one-time administration of Prednisolone is prescribed.

When angioedema appears during pregnancy, you should immediately consult a doctor, since untimely treatment leads to asphyxia and other pathologies. The main emergency medications for pregnant women are Calcium gluconate and a one-time injection of Prednisolone to block allergens.

What is used in first aid?

Prednisolone is used as first aid for angioedema. The medicine eliminates life-threatening symptoms and restores the functioning of internal organs in case of shock. Then you need to call an ambulance.

The doctor should provide first aid for swelling - reduce the body’s immune response to an allergen from the external environment. Measures that are necessary to eliminate swelling:

• To avoid suffocation and a sharp drop in blood pressure, it is necessary to inject Adrenaline into a vein or muscle. Dosage depends on age category sick person. Injections are given every 20 minutes.
• The hormonal drugs Dexamethasone and Prednisolone are used to relieve swelling and are given as injections, according to the age-specific dosage.
• Antishock drugs remove toxins from the patient's body. Popular medications are Hemodez and Reopoliglyukin.
• Intramuscular or intravenous administration of drugs with antihistamine properties - Suprastin or Diphenhydramine.

Is there anything I can do to prevent complications?

To avoid and prevent angioedema, an effective prophylactic agent is selected on an individual basis. Therapeutic drug therapy will help avoid repeated Quincke reactions. Basic actions to prevent pathology:

1. Following a diet, the purpose of which is to prevent the food allergen from reaching the mucous membrane of the larynx and trachea. Medicines containing substances that are life-threatening to the patient are also excluded.
2. If angioedema is inherited, preventive measures should be taken to avoid infection viral infections. The patient should also avoid stressful situations.

Forecast and prevention

When symptoms are identified and diagnosis is made, therapeutic therapy begins. To consolidate the result, prevention is carried out. The basic rule is to exclude the allergen from food, medicines and the environment.

In a person’s life, Quincke’s edema does not pose a big threat if you promptly seek help from a specialist.