Acute edema diagnosis
Edema Quincke (by the name of the German doctor N.I. Quincke, synonyms: angioedema, giant urticaria) - an acute allergic disease characterized by the appearance of massive skin edema, subcutaneous adipose tissue and mucous membranes. Most often, Quincke's edema develops on the face, neck and upper body, the back of the hands and feet. Less swelling of the Quincke can affect the membranes of the brain, joints, internal organs. Eden Quincke can be affected by any person, but the greatest risk of this disease is observed in people with allergies of various types. Young women and children suffer from Quincke's swelling more often than men and older people. At the heart of Quincke's edema is an immediate allergic reaction.
Diagnosis by symptoms
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Swelling of tissues is associated with increased vascularitypermeability caused by the release of mediators (histamine, prostaglandins, leukotrienes, cytokines, etc.) from sensitized mast cells, basophils when they come into contact with the allergen. As such an allergen may be food products (peanuts, chocolate, milk, exotic fruits, etc.), inhalable pollen or dust allergens, as well as medicines. In addition, the cause of the edema of Quincke may be the impact of various physical factors such as cold, bright sunlight, etc. The cause of the edema of Quincke may be the effect of various food, drug allergens (sulfonamides, antibiotics, acetylsalicylic acid, bromides, etc.), cosmetics , odors, increased sensitivity to cold.
A number of authors in the pathogenesis of Quincke's edema attachspecial significance of heredity, increased excitability of the autonomic nervous system, foci of chronic infection, diseases of the gastrointestinal tract. There are two types of Quincke edema: allergic and pseudoallergic. Quincke allergic edema, like other allergic diseases, arises as a result of a strong allergic reaction of the body, which develops in response to the penetration into the body of a specific allergen. Quincke's allergic edema is often combined with food allergy, bronchial asthma, urticaria, and hay fever.
Pseudoallergic Quincke edema (i.e. not allergic) develops in people with congenital pathology of the complement system. The compliment system is a group of blood proteins involved in the development of primary immune and allergic reactions. In human blood, these proteins are in an inactive state and are activated only at the time and place of entry into the body of a foreign antigen. In patients with pseudoallergic edema Quincke, the compliment system can be activated spontaneously or in response to thermal or chemical stimuli (heat, cold), leading to the development of a massive allergic reaction.
Typical symptoms of Quincke's edema are acutethe resulting swelling of the facial tissues, the back of the palms, the neck, the back of the feet. The skin is pale in the area of the edema. Quincke's edema, as a rule, is not accompanied by itching. The developed swelling disappears without a trace within a few hours or days. The most dangerous form of edema is the edema of the pharynx, larynx, trachea which is observed in every fourth patient with Quinck's edema. Such patients suddenly have anxiety, difficulty breathing, loss of consciousness is possible. Examination of the mucous throat in such patients reveals swelling of the soft palate and palatine arch, narrowing of the lumen of the pharynx. In case of spread of the edema to the larynx and trachea, the patient may die from suffocation. In children, Quincke's edema is manifested more or less limited foci of edema of the skin and mucous membranes. Quincke's edema of the internal organs is manifested by sharp pains in the abdomen, diarrhea, vomiting.
Diagnosis of angioedema is usually carried out onthe basis of the symptoms of the disease, the reaction of the edema to the injection of adrenaline. In some cases, Quincke's allergic edema to determine the causative allergen is carried out by allergological tests.
Quincke's edema treatment is aimed at suppressingallergic reaction. In all cases, one should be aware of the danger of injury to the respiratory tract and the death of the patient from suffocation. In cases where the patient develops symptoms of Quincke edema characteristic of the affected throat and larynx, immediately call an ambulance. A patient with laryngeal edema needs urgent hospitalization in an intensive care unit or intensive care unit. When treating Quincke's edema, the main thing is immediate removal of contact with the allergen (in cases where it is possible).
Apply antihistamines (dimedrol,Suprastin, Tavegil, Pipolphen, Claritin, Fenkarol, etc.) intramuscularly or in mild cases inward in tablets 2-3 times a day. Assign ascorutin, which reduces vascular permeability. When swelling of the larynx is additionally intramuscularly administered 25 mg of prednisolone hemisuccinate. According to the patient's testimony, he is hospitalized in the ENT department or under the supervision of a surgeon in connection with the possible need for tracheostomy. In severe cases of Quincke's edema, when there is a decrease in blood pressure, 0.1-0.5 ml of 0.1% adrenaline solution is injected subcutaneously.
First aid for swelling of Quincke
The first aid for Quinck's swelling includes: At the slightest suspicion of the development of Quincke's edema, an ambulance should be called forth immediately. The situation can change within a few seconds and the slightest delay is dangerous for the patient's life. Further it is necessary to eliminate the allergen that caused such a reaction, help the victim take a comfortable position and give antihistamines. Emergency care for Quincke's edema includes: 1) Intramuscular or intravenous administration of diphenhydramine, suprastin, claritin or other antihistamine. If there is no possibility to enter the drug intramuscularly, you need to put the pill to the patient under the tongue. 2) Subcutaneous administration of a 0.1% solution of epinephrine. 3) Administration of hydrocortisone hemisuccinate.
Prevention of edema of Quincke is inobserving a strict diet (with the exception of allergens), with the exception of allergens from the patient's environment, prophylactic antihistamines during the flowering plants, or contact with other allergenami.Profilakticheskie events are only possible in a situation when the cause of angioedema is installed. For example, in the case of a drug or food allergy, avoid taking medications or foods that cause angioedema. In addition, such patients should be carefully being treated all the centers of a chronic infection, such as carious teeth, chronic tonsillitis, helminth infections, etc. since they contribute to the general allergization of the body. Periodically, antiallergic drugs are prescribed for courses, for example, during the flowering period of plants with pollen allergy.
Questions and answers on the topic "Edema Quincke"
Question:Hello! At my mum (56 years) recently became very frequent edemas Quincke (doctors from neotlozhki have told or said). It all started with swelling of the lips and cheeks, and now went to the respiratory system. The allergist at the polyclinic assigns the same tests every time (lamblia, ascarids, immunoglobulin E total hepatitis and urine, total blood test, biochemistry), the results of these analyzes are always within the norm. Treatment is not appointed (there is really nothing to treat). From time to time you have to drink antihistamines, if it does not help, then a shot of dexamethasone. We ourselves assume that this is such a reaction to household chemistry (the last 2 times noticed edema just after using cleaning agents and powder). Prompt please, what it is necessary to hand over analyzes still to establish the reason of these edemas? Thank you very much in advance!
Answer: In a large number of cases, identify the causeedema Quincke in a laboratory way can not. In this situation, the most valuable are the observations of the patient and his associates. In addition, in order to determine the range of causes that could lead to the development of recurrent edema, a thorough history review is required. I recommend to change the allergist.
Question:Hello! I am 75 years old - never in all my life there has been any allergy, but over the past 1.5 years there have been 8 episodes of Quincke's edema. all this time I was taking from hypertension Renipril GT, could this medicine provoke the swelling of Quincke?
Answer: Hello! Of course, the cause of edema Quincke can be a medicine, household chemicals, food, blossom some herbs. You need to have always with you an antiallergic remedy for first aid. And as to pass or take place inspection at the allergist with the purpose of search of the causal allergen.
Question:Age 56 years. Since May, there is a period of edema of the Quincke of the lips and cheeks. It is removed in / in injections of suprastin and prednisolone. Accepted TSETRIN, edema was, KESTIN 10 days - the edema was. Samples for house dust and flowering plants are negative. KESTIN is prescribed for 10 ml every other day. On the face also demodekoz. Can he provoke swelling? How to identify the cause of edema?
Answer: The presence of any foci of infection, includingdemodicosis, can provoke the appearance of edema Quincke. Patients with Quinck edema should undergo a complete examination to detect pathology in any internal organ or system of the body, since angioedema can be the first manifestation of very many diseases. Address to the doctor-allergist and he will give you the full plan of inspection. If you are constantly taking any medications for other diseases, ask your doctor if they can cause angioedema. And try to analyze yourself, what has changed in your life in April-May this year.
Question:Hello. Prompt as it is possible to reveal an allergen at an edema quinte. For more than a month my mother has been going to doctors with complaints about a periodical swelling of the face and severe itching. The dermatologist has diagnosed - an edema a quincke. But except for a diet and prednisolone with Suprastinum of due treatment has not appointed or nominated. For today the picture has not changed, moreover there was an edema of the larynx. She "suppresses" suprastin in the hope of some improvement, but this does not happen. Can I make samples during an exacerbation? And what tests do you need to pass to confirm or deny the diagnosis?
Answer: With Quincke's edema, samples for allergens are notparamount action. I would recommend to your mother a hospital examination, taking into account the risk of developing a life-threatening condition (choking). The swelling is not always associated with an allergic reaction, in addition, given that it has happened repeatedly, your mother could determine the range of factors that, in her opinion, lead to the development of symptoms. The list of analyzes can be determined only by the results of a full-time examination.