Sudden swelling of the lips

Quincke edema is a disease that belongs to the group of allergic dermatoses, characterized by the sudden appearance of edema on the lips, neck, abdomen and other parts of the body

Edema can be localized or spread over large areas. The disease is dangerous in case of laryngeal edema, as it causes asphyxia.

This disease is most often affected by adults(men older than 25 years) than children, because in children allergic reactions manifest themselves as diathesis, dermatitis, childhood eczema. In the emergence of the disease, the hereditary factor plays a large role.

Quincke's edema is a clinical manifestationan allergic reaction of the body to the effect of an allergen. As a result, biologically active mediators are released from cells, causing expansion of capillaries and increased permeability of blood vessels with the release of blood plasma, which causes the appearance of edema.

The causes of edema Quincke

Allergens, which trigger the development of the disease,can be divided into two groups: exogenous allergens, endogenous allergens. In turn, these factors can be divided into several subgroups. Let's consider in more detail

Exogenous allergens that cause the onset of edema Quincke:

- Food allergens. One of the most common products provoking the occurrence of an allergic reaction is eggs. Moreover, the allergen in this case is not only egg albumen (egg albumin), but also yolk. Provocators are also products, based on the preparation of which involved chicken eggs. It can be cakes, syrniki, cutlets, biscuits, etc. There are fatal cases of laryngeal edema, which was caused by an allergy to chicken eggs. In some patients, there is an allergy not only to chicken eggs, but to chicken meat, as well as to chicken feathers.

On the second place among food allergens,provoking allergic reactions, is cow milk. The main substance of concern is B-lactoglobulin, which accounts for 7-12% of milk proteins. An allergy to cow's milk can manifest from the first days of life in the form of diathesis and bronchospasm, when new foods are introduced to newborns. That is why it is recommended to initially introduce lures from the lowest doses (2-3 drops of milk). In many people intolerance to cow's milk is manifested even through the intolerance of butter, sour cream, ice cream, etc. Such patients should be treated with particular attention, since the use of a few drops of milk or several grams of butter can cost them life. Therefore, for particularly sensitive and sensitive patients it is worthwhile to allocate a separate dish, which excludes the ingress of an allergen into food.

In addition to cow's milk and chicken eggs, Quincke's edemacan also cause a number of products, including: chocolate, nuts, seafood (crabs, caviar, fish, etc.), strawberries, strawberries, honey, mushrooms, watermelon, melon, carrots, spices, mustard, etc. When eating food allergens , in addition to edema Quincke, patients may manifest allergic rhinitis, conjunctivitis, bronchial asthma.

- Medicinal and chemical allergens. The drugs that most often provoke the appearance of edema Quincke are streptomycin, analgin, penicillin, insulin, acetylsalicylic acid, B vitamins, barbiturates, antihistamines. These drugs can cause an allergic reaction, both as a result of taking them inside, and as a result of external application.

- Inhalation allergens. The causes of seasonal edema Quincka is the pollen of plants (ragweed, wormwood, grasses, trees) at the time of its flowering. Also, allergens can be ordinary household dust, feather pillows, dry food for aquarium fish, printing inks of newspapers and magazines. Allergens can be domestic animals (in particular, pet hair): cats, dogs, rabbits. Often, the edema of Quincke in this case is accompanied by manifestations of rhinitis, sinusitis, bronchial asthma.

Contact allergens. In this case, a provocateur for the appearance of edema Quincke is the direct contact with the substance-allergen. It can be: pets, silk fabrics and decking, washing powders, detergents and cleaners. As an allergic reaction can provoke the use of cosmetics: lipsticks, powders, creams, gels, toothpaste. In this case, allergic reactions occur not only locally, that is, in the place of contact with the allergen, but also throughout the body.

- Fungal and bacterial allergens. Allergic reaction can cause bacterial allergens: streptococci, white and golden staphylococcus, E. coli, etc. The focus of infection in this case can be teeth, affected by caries, purulent formations and cysts, chronic cholecystitis, pyelitis.

- Intestinal parasites. In this case, allergen is quite toxic products of vital activity of intestinal parasites, especially ascaris.

- Insect bites. Quincke's edema can also be caused by insect bites: wasps, bees, hornets, mosquitoes and bedbugs.

Endogenous allergens that provoke the onset of Quincke edema:

Edema, often, can appear in patients,suffering from chronic diseases of the pancreas, liver and gastrointestinal tract. Such patients are at risk because, due to these chronic diseases, they have insufficient digestive capacity of gastric juice, as well as insufficiency of important pancreatic enzymes. As a result of the inadequate ability to digest food, its unprocessed parts (most often proteins) enter the intestines, provoking the development of colitis and enteritis. In turn, the affected shell of the intestine begins to absorb toxic and allergenic substances that provoke the onset of Quincke edema.

In the risk zone are also pregnant womenand women with menstrual irregularities, as a change in the hormonal background can cause an exacerbation of the edema of Quincke. Also, risk factors are such diseases as hyperthyroidism and diabetes mellitus. In addition, particularly vulnerable to the onset of the people suffering from neuroses, psychoses, depression and other disorders of the central nervous system.

Symptoms and Diagnosis of Disease

Quincke's edema develops rapidly and is capable oflast from several hours to several days. Most often the edema affects the area of ​​the lips, eyelids, feet, palms, ears, scrotum, scalp. Symptoms of edema disappear without a trace, but if the edema appears quite often in one area, traces of a small swelling may remain outside the stage of exacerbation. Sometimes the edema affects the area of ​​the tongue, which greatly increases and does not fit in the mouth.

But the most dangerous area, which is affected by edemaQuincke, this is the larynx. Laryngeal edema occurs in 25-30% of cases. The edema develops swiftly, the patient feels attacks of suffocation. There is a raucous breath, the face pales, then acquires a bluish tinge, the skin becomes covered with sweat. With mild attacks, edema lasts from a few minutes to half an hour, then passes. After a swelling for a while, the patients experience breathing difficulties, have a hoarse voice, occasionally cough. In severe cases, only tracheotomy helps to get rid of edema, otherwise the patient dies of asphyxia.

Quincke edema can be accompanied by abdominalsyndrome (edema that has spread to the esophagus, stomach and intestines). This disease is very difficult to diagnose. The patient initially feels an acute pain in the abdominal area, then begins to ripen food, then tears a light liquid with a bile admixture. Patients have a loose stool with blood impurities. Edema of the brain tissue and inner ear can be accompanied by clinical symptoms such as eyelid edema, lips, sharp lethargy, headache, seizures, epileptiform seizures, visual disturbances, nausea and vomiting. These phenomena disappear after a spinal puncture.

Diagnosis of the disease is not difficult. It is important, first of all, to establish data of allergological anamnesis (heredity, the presence of primary attacks of the disease, etc.). The only difficulty is the diagnosis of abdominal syndrome (edema of the mucosa of the esophagus, stomach and intestines). However, this syndrome can also be diagnosed with esophagogastroscopy. With Quincke's edema, no characteristic changes in the blood test are observed. In some patients, the level of leukocytes rises, in others - of lymphocytes, the third has a stab-shift, etc.

Prophylaxis and treatment of edema Quincke

One of the most effective methods of prevention andtreatment of the disease is the termination of contact with the detected allergen (drug, food, household item, wool, chemical, etc.). In the event that allergens are feather pillows, house dust, pollen of plants and other substances with which the termination of contacts is not possible, then apply a specific hyposensitization. Patients are prescribed the use of antihistamines.

If the allergen is a food product, thenpatients are prescribed a strict diet. This diet is based on the restriction of the use of carbohydrates (especially sugar), liquid and table salt. In the diet of the patient is introduced an increased amount of fats and proteins, vitamins A, C, and P. We recommend the use of broth of wild rose, fruit and berry juices, liquid brewer's yeast. The diet excludes the use of spicy dishes, spices, salted, fried and smoked dishes, alcohol, chicken eggs, pork, nuts, beans, citrus. In a day, 150 grams of protein, 150 grams of fat, 200 grams of carbohydrates should be consumed. The total daily amount of calories should not exceed 2800.

As prophylactic methods, a permanent sanation of foci of infection, capable of causing an allergic reaction (carious teeth, chronic tonsillitis, etc.) is carried out.

Patients with laryngeal edema and with abdominal syndrome need urgent hospitalization in the surgical department.

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