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Do not run your disease
Edema Quincke (other names - acute edema Quincke,giant urticaria, edema caused by trophic changes, angioedema) is a spontaneously limited or widespread swelling of the subcutaneous tissue and mucous membranes. Quincke's diseases are susceptible to adults and children, but more often the disease manifests itself at a young age, especially in female patients. In children and the elderly it does not appear often.
The main role in edema arising as a componentan allergic reaction is played by the sensitivity of the organism to the antigen-antibody allergen. Biologically active mediators (histamine (which is one of the mediators of allergic reactions), kinins, and progestaglandins) formed in the early sensitized organism cause a local increase in the finest vessels and veins, an increase in the transmissive capacity of microvessels and an excess accumulation of fluid in the tissues. The cause of edema may be the effect of certain foods (eggs, fish, chocolate, nuts, berries, fruits, milk), medicinal and other allergens (a substance capable of causing allergies) (flowers, animals, insect bites).
In patients with hereditary edema Quinckethe disease is caused by a hereditary factor. Inheritance proceeds according to the dominant type. In the serum of patients, the number of inhibitors (suppress or delay the course of physiological and physicochemical processes) of C-esterases and kininogenin is reduced. Quincke's disease in this case, like the edema arising as a component of the allergic reaction, progresses under the influence of in-in, which cause the development of the same allergens. Excessive accumulation of fluid in tissues progresses in the body with increased sensitivity under the influence of special allergens: flowers, animals, food, medicines, cosmetics or nonspecific: psychological stress, poisoning, infection, general cooling of the body. Favorable factors can be liver disease, thyroid gland (especially with its reduced function), stomach, blood diseases, auto-allergic and parasitic diseases. In many cases, the disease acquires a chronic, recurring course.
In a number of situations, the cause of Quincke's disease can not be determined (the so-called edema arising without any apparent cause).
The disease begins to flow spontaneously. For a couple of minutes, not so often hours, on various areas of the face and mucous membranes, a pronounced edema progresses. Local edema of the lips, eyelids, scrotum, and mucous membranes of the mouth (tongue, posterior moving part of the sky, tonsils), respiratory tract, gastrointestinal tract, urogenital zone are possible. Edema is not often accompanied by pain, much more often patients complain about a feeling of tension of tissues. In the area of excess fluid accumulation in the tissues, the tension of the elastic tissues is observed, when pressure is not applied, the examination of the patient with the help of palpation of the swelling does not cause pain.
Most often, Quincke's disease occurs on the lowerlips, eyelids, tongue, cheeks, larynx, while excessive accumulation of fluid in the tissues of the larynx and the tongue can lead to the occurrence of choking - it becomes difficult to breathe, there are no sonorous voices with the safety of whisper speech, cyanosis of the tongue.
When the edema spreads to the brain of the brain's head and shell, neurological dysfunctions develop (seizures resembling epileptic, speech disorders, muscle paralysis of one half of the body, etc.).
Quincke's disease can persist for a couple of hours or days, then disappears without a trace, but can sometimes resume.
The most dangerous complication may bethe progression of excess fluid accumulation in the tissues of the larynx with growing signs of acute respiratory failure. Signs of excessive accumulation of fluid in the tissues of the larynx - hoarseness of the voice, loud abrupt dry cough, developing difficulty breathing.
Swelling of the mucosa of the gastrointestinal tract may impart itselffor acute abdominal pathological condition, with the possible disturbance of digestion disorders, acute pain in the abdomen, increased wave-like contractions of the intestine, in some cases - signs of inflammation of the peritoneum.
Disorders of the health of the genitourinary system is characterized by signs of acute development of cystitis and can lead to acute urinary retention.
The most severe is the location of the edema inface area, because this may involve the involvement of the brain shells with the formation of brain signs or labyrinth systems, which is characterized by the symptoms of Meniere's syndrome (periodic occurrence of sudden dizziness attacks) (dizziness, nausea, vomiting). If there is no urgent, highly qualified care, this excessive accumulation of fluid in the tissues can lead to death.
A combination of acute urticaria and Quincke's disease can occur.
Distinguishing this disease from othersis performed with complete cessation of lymph flow, edema of interphalangeal joints of the hand with inflammation of the periosteum, erysipelas (characterized by rapid flow and formation of subepidermal blisters), Melkerson-Rosenthal syndrome. When the signs of Melkerson-Rosental together with the edema of the lip of the chronic course, the folding of the tongue and the nerve of the face are detected. With erysipelas, there is an increase in blood flow (redness) near the lesion in the form of tongues of flame.
Elena Malysheva talks about Quincke's swelling in the TV program "Live healthy!"
First Aid for Quinck's Swelling
- With a decrease in the arterial pressure, 0.1-0.5 milliliters of 0.1% of epinephrine is injected under the skin;
- In case of suffocation (swelling of the mucosa of the respiratory tract), injection of epinephrine;
- Treatment with hormones: glucocorticoid hormones (prednisolone 60-90 mg intramuscularly or intravenously, dexazone 8-12 mg intravenously);
- Antiallergic therapy: antihistamines (suprastin 2% - 2.0 intramuscularly, Claritin, Zirtek, Erius, Telfast);
- Diuretic drugs: Lasix 40-80 mg intravenously stooled in 10-20 milliliters of saline solution;
- Medicinal preparations inhibitorsproteolytic enzymes: contrikal - 30000 units intravenously in 300 milliliters of saline, epsilon-aminocaproic acid 5% - 200 mililiters intravenously through a dropper, then - 100 milliliters after 4 hours or 4 grams 4-5 times a day until the reaction stops completely;
- Directed to neutralize toxic substances inbody therapy - a method of removing toxins from the body by extracorporeal perfusion of blood through granular or plate sorbents, enterosorption;
- Placement in the hospital in the department of allergology;
- Gradual therapy of excess fluid accumulation in tissues;
- Elimination of interaction with the allergen;
- Prescribing drugs to increase the activity of the sympathetic nervous system (calcium medicines, vitamins C, ephedrine);
- Decrease of parasympathetic mobility (atropine) and the amount of histamine (it is one of the mediators of allergic reactions) (dimedrol, suprastin, tavegil);
- Treatment of diseases with vitamin means is required - prescribe ascarutin to lower the transmissive capacity of blood vessels;
- The use of antiallergictherapy (Adrenocorticotropic hormone, adrenal cortex hormone, prednisolone) course of therapy with vitamins B and gamma globulin (fraction of plasma immunoglobulins);
- The basis for the treatment of a hereditary variety of Quincke's disease is drugs that enhance the production of an absent C1 inhibitor in the human body;
If there are no contraindications to hormonal therapy, it is recommended to lead in the hospital.
The only correct prevention is avoiding interaction with allergens (a substance capable of causing allergies).
Author: Dr. med. Utenkova Elena Vasilevna