The disease is characterized by swelling

OTEK QUEEN. The general concept.

Allergic diseases occupy a leadingplace among medical problems around the world. The XXI century, according to the forecasts of experts of the World Health Organization, can become a century of allergy: it already affects every fifth inhabitant of the planet. According to the statistics of many countries in the world (Germany, England, France, etc.), between 10% and 30% of urban and rural populations living in regions with highly developed economies suffer from allergic diseases. It is found in every sixth American and every fourth German. In Russia, depending on the region, allergy sufferers are 5-30%, Ukraine - 20-30%. And in Belarus only 2-5%. Such a small proportion is associated with insufficient detectability: as a rule, people with symptoms of this disease do not turn to a specialist for years, often do not associate some forms with an allergic nature.

Angioedema (first described by H. I. Quinke in 1882) is a hereditary or acquired disease characterized by the appearance of edema of deep layers of the skin, subcutaneous fat, and mucous membranes of various organs and systems (respiratory, digestive, urinary), which disappears in most cases up to 72 hours. Angioedema (AO) most often appears in the head and neck area, including the face, lips, tongue, throat, but can occur in any part of the body.

In some cases, AO can lead to a fullobstruction of the respiratory tract and death (laryngeal edema, laryngeal edema). In 46-49% of cases, a combination of angioneurotic edema with urticaria is noted, which can be defined as a limited area of ​​edema and hyperemia of the dermis with uneven borders, possible fusion and blistering. The main role in the pathogenesis of angioneurotic edema is played by the mediators released during the degranulation of tissue basophils (mast cells) and basophils of blood. Under their influence, vasodilation occurs, vascular permeability increases and itching develops. At the basis of urticaria there is an acute, limited edema of the papillary layer of the dermis and widening of the capillaries. Quincke's edema and urticaria have common mechanisms of development and differ only in the depth of edema. With angioneurotic edema it extends to the deeper layers of the dermis. In view of the predominance of cases of edema of an allergic nature, usually the term angioedema refers to allergic angioedema, which can be given another definition - giant urticaria. When establishing a complement-dependent development mechanism, AOs now prefer to use the term hereditary angioedema (NAO). In 1972, another type of edema was described, defined as "acquired angioedema," associated with various lymphoproliferative and autoimmune diseases that disrupt the functioning of the complement system (SC). Allergic angioedema, angioedema, is mediated by an allergic reaction of an immediate type and is one of its most characteristic clinical manifestations. Most often in everyday clinical practice, there is an allergic AO.

Up to 80% of the causes of AO - the development of an allergic reactionI type according to Gell P. Coombs R. (1969): - reactive (IgE-dependent type), at which the release of mediators (mainly histamine, as well as prostaglandins, leukotrienes, bradykinin, platelet activating factor and others) from mast cells and basophils in the interaction of the allergen and the IgE located on these cells. Mediators cause vasodilation, increased vascular permeability and cellular infiltration, which is clinically manifested by swelling of the tissue. Various factors can lead to the development of an allergic AO: - drugs (antibiotics, sulfonamides, B vitamins, plasma, immunoglobulins); - food products (fish, crustaceans, milk, eggs, nuts, legumes, tomatoes, citrus fruits, stone fruits, strawberries, chocolate, cheese); - Some biologically active additives ("Chinese tea", traditional medicine, containing highly allergenic products of animal and vegetable origin); - poison of stinging insects (bees, wasps, hornets); - Latex (gloves, condoms, rubber urinary catheters, intubation tubes, intravenous catheters); epidermal allergens - saliva, dander of cats, dogs, other warm-blooded; - cosmetical tools. For allergic edema are characteristic: a clear connection of the effect of the allergen and the development of the reaction, an acute onset - usually the reaction develops 15-30 minutes after contact with the allergen, the rapid development of edema, a combination with urticaria. Edema of a characteristic type - usually a dense, asymmetric, painless edema, can be pale pink and not differ from unchanged skin. It is localized mainly in places with well-developed subcutaneous fat (on the face it is often lips, eyelids, in the oral cavity - soft palate, tongue, amygdala). Involving the mucous respiratory system (swelling of the larynx, trachea, bronchi) is especially dangerous because of the threat of asphyxia development. Patients experience a feeling of heaviness, tension, perspiration in the throat.

The earliest symptom of the laryngeal edema is the hoarseness of the voice, then there are disturbances in swallowing and difficulty breathing.

It is possible to develop a joint-stock company as a generalizedanaphylactic reaction - anaphylactic shock - anaphylactic shock, which is manifested by generalized itching, urticaria, lachrymation, sneezing, bronchospasm, tongue edema, larynx, pharynx, hoarseness, hypersecretion of mucus in the bronchi, nausea, vomiting, cramping abdominal pain, diarrhea, tachycardia, arterial hypotension, violation heart rhythm, the development of acute cardiovascular insufficiency, seizures, respiratory arrest, coma. In this case, death comes from the swelling of the larynx and the disturbance of the heart rhythm.