Nabryak quinque. Provoking factors and allergens. What does idiopathic form mean?

Allergic reactions are an integral element of people's lives. It's hard to say why allergic diseases are so common, but the fact that people experience a certain form of allergy at least once in their lives is undeniable. The topic of conversation will be Quincke's edema, its symptoms and treatment at home.

Quincke's edema is an inflammation skin, predominantly localized in the lips and around the eyes. This phenomenon is considered the result of an allergic reaction leading to increased production of histamine in the human body. Excess histamine leads to inflammation of blood vessels.

At the beginning of the twentieth century, the Austrian scientist Mendel, describing the signs of angioedema, gave the complex of symptoms the name “Quincke’s edema”, in honor of the German doctor. IN medical literature There is also another name - “giant urticaria”.

4 types of angioedema

Doctors, depending on the causes of occurrence, distinguish several types of Quincke's edema.

1. Allergic . The most common type. Develops in people suffering food allergies. Appears after eating certain foods, insect bites, using Aspirin and Penicillin. Allergic giant urticaria is not a chronic disease, since you can determine the food that caused the allergy and stop eating it yourself.
2. Medication . Appears due to medications that cause tumors in the deep layers of the skin. Even if a person stops taking the drug, symptoms of edema persist for a long time. Usually the medicinal type is side effect non-steroidal anti-inflammatory drugs, proton pump inhibitors.
3. Idiopathic . It got its name because of the difficulty of identifying the causes of its occurrence. According to scientists, the development of edema is promoted by infection, stress, alcohol, fear, overheating, anxiety and even tight clothing. It is believed to be caused by thyroid problems and folic acid deficiency.
4. Hereditary . An extremely rare type of angioedema. It usually develops in people who have inherited a defective gene. It is characterized by the gradual development of symptoms that appear after puberty. Pregnancy, injury, infection, and even the use of contraceptives contribute to the development of symptoms.

At the beginning of the article, I introduced you to Quincke's edema, listed and described the types and places of its occurrence. The time has come to dwell in more detail on the causes, main symptoms and, of course, treatment with folk remedies and medications.

Symptoms of Quincke's edema in adults and children

Anyone can become a victim of angioedema, but allergy sufferers are most susceptible to it. In men and older people, Quincke's edema develops much less frequently than in children and young women. The disease is extremely rare in infants.

If Quincke's edema develops on the face, neck, feet and hands, the symptoms are pronounced. It is more difficult if the disease manifests itself in the joints, lining of the brain and internal organs.

1. Swelling. Edema – main external symptom. Signs of swelling appear on the abdomen, chest, genitals, neck, lips, eyelids, nasal mucosa and larynx. There are sensations of skin tension. The rate of spread of edema is very high. Without qualified help, it can lead to anaphylactic shock.
2. Decreased pressure . The allergy that causes the disease can be manifested by a drop in blood pressure, which is caused by impaired circulation due to edema. The neoplasm compresses the blood vessels and slows down the movement of blood. The patient feels pain in the temples and dizziness.
3. Nausea and vomiting . Pressure surges cause nausea and sometimes vomiting. Normal allergies are not accompanied by such symptoms, unlike Quincke's edema.
4. Heat . Tissue swelling resembles inflammatory process. In the affected area, blood flow is abnormal, causing the temperature to rise. If it does not exceed 38 degrees, as with the flu, there is no need to use antipyretics.
5. Blue tongue . Caused by swelling of the mucous membrane of the nasopharynx and larynx. Poor circulation and lack of oxygen can cause other parts of the body to turn blue.
6. Edema meninges . Symptoms characteristic of acute meningitis appear: headache, dizziness, severe nausea, fear of light, convulsions and other neurological disorders.
7. Edema of the genitourinary system . Clinical picture resembles an attack of cystitis, accompanied by pain and urinary retention.
8. Swelling of internal organs . Quincke's edema is accompanied by severe abdominal pain, without a specific localization.
9. Joint swelling . The disease causes limited mobility and swelling of the joints. At this moment, inflammatory processes do not occur in the joints.

Usually people experience swelling of the face and mucous membranes. Quincke's edema is potentially life-threatening and if symptoms appear, you should immediately seek help.

Causes of Quincke's edema

Continuing the topic of conversation, I will consider the causes of angioedema in adults and children. During normal operation immune system histamine is inactive. When an allergen enters the body and accumulates, mediators begin to quickly be released. Veins dilate, production increases gastric juice, spasms of smooth muscles appear, pressure decreases. Let's figure out which allergens cause giant urticaria.

• Food. Eggs or products containing them - cutlets, baked goods, cheesecakes. Can lead to Quincke's edema cow's milk. It contains lactoglobulin, which causes an allergic reaction. Often intolerance appears after consumption butter or cottage cheese. Sweet soda, alcohol, honey, spices, and strawberries can trigger allergies.
• Chemical and medicinal . Many medications lead to angioedema. Among them: acetylsalicylic acid, insulin and various antibiotics. The method of administration of drugs does not matter.
• Inhalation . The list of allergy-provoking factors includes plant pollen, poplar fluff, dust, pillow feathers, and dry pet food.
• Contact. Quincke's edema begins after a person comes into contact with causing allergies substance. For example: paint and varnish products, cleaning and detergents, cosmetics.
• Bacterial and fungal . In some people, giant urticaria is caused by E. coli, staphylococci, or streptococci. The source of infection is usually localized in teeth affected by caries or in a cyst with suppuration.

For the appearance of Quincke's edema with hereditary predisposition no accumulation of allergens is required. Even their slight exposure causes allergies. The risk group includes people with nervous disorders, diabetes, chronic diseases, pregnant women and women during menopause.

Treatment of angioedema in adults and children

The disease in question is acute, causing potential threat for a person’s life, an allergic reaction, which manifests itself as the unexpected occurrence of large-scale swelling of the skin, subcutaneous tissue And muscle mass.

Typically, people over twenty years of age experience Quincke's edema. It appears much less frequently in older people. In children, allergies are hereditary and develop to impressive sizes. It is often accompanied by urticaria.

Treatment of edema in children is more difficult because they cannot give correct assessment to your well-being. Therefore, parents have to carefully monitor the child’s reaction. Read below how Quincke's edema is treated in adults and children.

First aid for Quincke's edema

If symptoms of Quincke's edema appear, you should immediately seek help. But the mission doesn't end there. Before the ambulance arrives, the patient should be given emergency care.

First aid techniques for angioedema are described below. Before moving on to action, you need to calm down yourself and reassure the patient. Believe me, everyone's worries will not help the matter.

1. If the allergen is known, contact with it should be promptly interrupted. It would not hurt to open the windows, remove constrictive clothing from the patient, and unfasten collars and belts.
2. The patient should always be in a sitting or reclining position. In this position it is easier for him to breathe. It is considered a very effective measure hot bath for legs. Pour into a wide container so much hot water as much as the patient can bear. Periodically add hot water until the doctors arrive.
3. Apply something cool to the swelling. Can be used soaked in ice water towel. Place vasoconstrictor drops into the patient's nose. Ideal option Naphthyzin is considered to be used for a runny nose.
4. After the ambulance team arrives, the doctors will administer a decent dose of antihistamines to the patient and take him to the clinic. You should not refuse hospitalization even if your condition improves significantly.
5. IN mandatory inform doctors what measures were taken before their arrival. If the development of edema is associated with a specific event, this should also be mentioned. This information is incredibly important for diagnosis and treatment decisions.

Video tips for first aid for Quincke's edema

I sincerely hope that throughout your life you will not have to use this information in practice. If trouble happens, remain calm and confidently act according to the instructions.

Medicines

Treatment of angioedema involves the use of medical supplies. Any other methods are inappropriate. This is worth remembering for people who are accustomed to using folk remedies. Their use for allergies is contraindicated.

Drug-based therapy must be implemented quickly. Even a slight delay can lead to severe complications, deep loss of consciousness or fatal outcome.

• Antihistamines . Reduces the body's sensitivity to the allergen. Their list includes Suprastin, Tavegil and Diphenhydramine.
• Hormonal injections . Just one shot hormonal drug will reduce swelling and eliminate spasm. Dexamethasone, Hydrocortisone or Prednisolone are used for this purpose.
• Muscle relaxants . There are often cases when Quincke's edema leads to an attack of asphyxia. Then doctors intubate the trachea with a special tube that makes breathing easier. Next, muscle relaxants Ephedrine or Adrenaline are prescribed.
• Glucocorticoids . Hormonal agents stop many allergy symptoms and prevent anaphylactic shock. Such drugs are used together with drugs containing sodium and calcium.
• Diuretics. Supportive treatment involves the use of diuretics. They relieve swelling because they accelerate the removal of moisture from the body and normalize blood pressure. The most effective diuretics are Phytolysin and Canephron.
• Vitamin complexes . Use of vitamins – adjuvant therapy. Vitamins help an exhausted body recover from an allergic reaction. It is customary to strengthen the immune system with the help of ascorbic acid and B vitamins.

I think it’s now clear why you can’t fight Quincke’s edema using traditional methods. If complications arise, it is simply impossible to help the patient at home.

Folk remedies

Angioedema should only be treated with medication; self-medication for this serious disease can be harmful. Clinical manifestations of Quincke's edema develop rapidly; the use of folk remedies at the time of exacerbation can lead to death. Doctors should do the treatment.

Folk remedies are allowed to be used after the attack has subsided. They will help prevent relapse. But even in this case, it is necessary to choose and use a folk remedy after consultation with a doctor.

1. Herbal collection . To prepare, combine in equal quantities alder and rosehip fruits, immortelle flowers, string and horsetail herbs, roots of aralia, dandelion, burdock, elecampane and licorice. Pour a glass of boiling water over a spoonful of the mixture, steam for 30 minutes, cool, filter, and add boiling water to make 200 ml of liquid. Drink 0.33 glasses three times a day after meals.
2. Nettle infusion . To prepare 10 grams of dead nettle, pour 250 ml of water. It is recommended to consume one third of a tablespoon three times a day.
3. Ephedra infusion . Two grams of chopped plant branches are poured into 250 ml of boiling water. Drink 100 milliliters three times a day, constantly monitoring arterial pressure.
4. Datura tincture. Pour a spoonful of Datura powder into 150 ml of high-quality vodka, leave for a week and take three times a day. A single dose should not exceed 15 drops.

In a person prone to allergies, home remedy plant origin may cause the development of individual intolerance. Therefore, folk remedies must be used carefully.

Quincke's edema is an acute allergic reaction that occurs suddenly, the manifestation of which is severe swelling of the mucous membranes, skin and subcutaneous fat. It most often develops on the face, neck, chest, hands and feet.

Sometimes it spreads to internal organs and joints. In severe cases, the brain is involved in the process. This pathology can occur in any person, but according to statistics, it is most often observed in women and children.

Quincke's edema - causes

According to etiological factors, Quincke's edema is divided into:

Pseudo-allergic;

Allergic;

Idiopathic.

1. Pseudoallergic - is a manifestation of a congenital pathology of the complement system. It represents blood proteins that are directly related to primary allergic and immune reactions. IN in good condition these proteins are inactive. Their activation occurs when a foreign antigen enters the body. In this case, the complement system can be activated both spontaneously and in response to various stimuli(chemical or thermal), causing a widespread allergic reaction. That is, angioedema can develop due to hypothermia or overheating, with a bruise, or with skin contact with any chemical.

2. Allergic angioedema occurs when a specific allergen is introduced into the human body. In response to this in large quantities Substances that act as vasodilators (bradykinin, etc.) are released into the blood. Under their influence, the permeability of the walls of blood vessels sharply increases, which leads to the entry of the liquid part of the blood into the surrounding tissues. As a result, the distance between the cells increases, and accordingly the tissue increases in volume - edema forms.

With angioedema, the causes of allergic angioedema can be:

Food products (most often citrus fruits, seafood, chocolate, nuts);

Plant pollen;

Various insect bites;

Down, feathers, animal and bird hair;

Household chemicals;

Medications.

3. Idiopathic angioedema occurs without visible reasons when it is impossible to find out the root cause of its development.

Predisposing factors are:

Pathology of the thyroid gland;

Diseases of the digestive system;

Autoimmune diseases;

Helminthiasis;

Blood diseases;

Stress;

Surgical interventions, including dental ones;

Pregnancy;

Taking contraceptives.

Quincke's edema may develop in the second week of use ACE inhibitors(angiotensin-converting enzyme) - drugs used in the treatment of hypertension (captopril, enalapril, ramipril, etc.). During their action, the level of the enzyme angiotensin II decreases, leading to an increase in the release of bradykinin into the blood. This can lead to Quincke's edema.

Quincke's edema often develops chronic course and occurs with relapses.

Quincke's edema - first symptoms and signs

The beginning is always sharp. With Quincke's edema, the first symptoms develop rapidly within a few minutes. The pathology is manifested by local swelling of the mucous membrane of the oral cavity, eyelids, lips, scrotum, respiratory and genitourinary systems, gastrointestinal tract. intestinal tract.

With Quincke's edema, signs of a pathological condition, in addition to swelling of the mucous and soft tissues, are:

Blueness and swelling of the tongue;

Anxiety;

Sometimes - loss of consciousness.

The most dangerous form This pathology involves the larynx, pharynx, and trachea in the process. This occurs in 25% of cases of angioedema. Accompanied by swelling of this localization the following symptoms:

Difficulty breathing up to an attack of suffocation;

Barking dry cough;

Aphonia;

Loss of consciousness.

Upon objective examination it is clearly visible sharp narrowing lumen of the pharynx due to edema soft palate and palatine arches. Further spread of angioedema to the larynx or trachea can be fatal due to possible suffocation.

If the process involves internal organs, vomiting occurs, loose stool, sharp paroxysmal pain in the abdomen - a condition develops that clinically resembles acute stomach.

When the brain is involved, clear symptoms of the lesion appear nervous system:

Hemiplegia;

Convulsive attacks;

Signs of Meniere's syndrome: severe dizziness, nausea, vomiting.

When edema spreads to the urogenital system, a clinic appears acute cystitis up to anuria (acute urinary retention).

Quincke's edema - treatment

If angioedema develops, treatment should begin immediately, since in severe cases, timely medical care largely determines the prognosis for life.

Since Quincke's edema is a life-threatening condition, if it develops, an urgent call to the ambulance is necessary, especially if this pathology occurs for the first time.

Indications for hospitalization:

Swelling of the tongue;

Edema respiratory tract, manifested by difficulty breathing, an attack of suffocation;

Intestinal edema accompanied by sharp pains, vomiting, diarrhea;

Inefficiency therapeutic measures carried out at home.

Before the ambulance arrives, treatment is as follows:

Clearing the airways;

Checking breathing, pulse, blood pressure;

Administration of medications: adrenaline, glucocorticosteroid, antihistamine - in exactly this sequence.

Adrenaline is administered intramuscularly in the prehospital period in a standard dose of 0.3 - 0.5 ml of a 1% solution. If the result does not occur, the injection is repeated every 15 minutes.

Action of adrenaline:

Sharply reduces the flow of histamine, bradykinin, etc. into the blood;

Normalizes blood pressure;

Reduces bronchospasm;

Supports cardiac activity.

Glucocorticosteroid drugs are administered in the following dosages, depending on the severity of the condition: dexamethasone - 8 - 32 mg, prednisolone - 60 - 150 mg.

Action of glucocorticosteroids:

Reduce inflammation, swelling, itching;

Stabilize blood pressure;

Stops the release of mediators from mast cells(histamine, kinins, prostaglandins), leading to sharp increase vascular permeability and the development of an allergic reaction;

Relieves bronchospasm;

Improves heart activity.

Antihistamines have effects similar to those of hormones. H1 blockers are used - histamine receptors(suprastin, loratidine, clemastine, tavegil, diphenhydramine, etc.). The effectiveness of antihistamines increases with joint use with H2 receptor blockers (ranitidine, famotidine, etc.).

During hospitalization, the threat to life is first eliminated - airway patency is restored if this could not be done at the previous stage. If necessary, tracheal intubation or conicotomy is performed.

In a hospital setting, treatment is continued, with the following being introduced step by step:

1. Preparations of protease inhibitors (aminocaproic acid).

2. Desensitizing therapy (sodium thiosulfate).

3. Detoxification therapy (parenteral administration of Reosorbilact, Ringer's solution, etc.).

4. Etherosobents orally (Atoxil, Enterosorb, Polysorb, etc.)

5. Diuretics (furosemide).

6. To reduce permeability vascular walls- ascorbic acid.

7. If necessary, hemosorption and plasmapheresis are performed.

A strict hypoallergenic diet is followed for the entire treatment period. In the future, the diet is gradually expanded, but for a long time it is necessary to exclude alcohol and foods that are potential allergens.

For pseudoallergic (hereditary) Quincke's edema, the following must be administered:

C1 - inhibitors;

Native plasma, if available;

Antifibrinolytics (aminocaproic, tranexamic acid);

Androgens (methyltestosterone, danazol, stanazol);

GCS, diuretics - for swelling of the face and neck.

There are contraindications to the administration of androgens. Do not administer to children, during pregnancy and breastfeeding, or with a prostate tumor.

Quincke's edema - prevention

For Quincke's edema, prevention includes a number of hygiene measures and some rules for nutrition and lifestyle, the observance of which will help to avoid the development of this condition, which is dangerous to health and life. First of all, it is necessary to take measures to avoid contact with allergens:

Conduct regular wet cleaning in the apartment;

Ventilate the room;

Wipe off dust;

Get rid of feather and down pillows and blankets;

Avoid pets if you have experienced angioedema on animal fur in the past;

Observe hypoallergenic diet;

Treat existing chronic diseases in a timely manner.

If angioedema has ever developed, you need to always have an antihistamine, adrenaline and prednisolone (dexazone) in ampoules with you. In case of impossibility parenteral administration For these medications, you can pour the contents of the ampoules under the tongue - the drugs are quickly absorbed by the sublingual veins, and the effect occurs very quickly.

For angioedema, the prevention of hereditary (pseudoallergic) angioedema is to take androgens 6 days before (if there are no contraindications) or aminocaproic acid orally 2 days before surgery or dental procedures. Infusion of aminocaproic acid for this purpose is carried out immediately before surgery.

Quincke's edema is a life-threatening condition, so it must be treated with full responsibility and all measures must be taken to prevent it.

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 may 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. At the same time, Quincke's edema, or angioedema, is considered the most dangerous manifestation immune response. The reason for this is high risk 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 with more simple explanation The reader can familiarize himself with this phenomenon further.

Thus, Quincke syndrome occurs due to contact of a sensitized (sensitive) organism with an allergen. Edema develops due to increased vascular permeability, which is accompanied by the release of intercellular space large amounts of liquid. Actually, this is the reason for the increase different parts 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 certain type illness, signs of Quincke's edema may be of the following nature:

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 baby hygiene products for chemical basis.

Quincke's edema in children, as a rule, is manifested by swelling of the face, lips, genitals, feet and is not accompanied by urticaria. 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 various reasons, which are identified through laboratory tests. In addition, developing the topic “Allergic angioedema - symptoms in adults,” it is important to say that the active part of the population often experiences symptoms of abdominal syndrome:

• uncontrollable vomiting;
• sharp painful sensations in a stomach;
• diarrhea.

Treatment of Quincke's edema in adults is somewhat different from therapeutic measures, used in 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 when severe cases allergies (when the throat swells), it is vital for a person to receive timely medical care. 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 medications, 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 should be taken to the nearest home medical institution. In addition, in medical reference books there are entire sections devoted to the topic “Quincke’s edema - urgent 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. Conduct to the patient artificial respiration if he 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. On the background beneficial effects of this algae on the skin receptors, the swelling goes away 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 stop the syndrome. However, before using any product, it is imperative to check its components for allergenicity. Among the most effective traditional methods elimination of Quincke's edema can be distinguished:

1. Milk with soda. Known remedy Combating a sore throat can also be used to relieve allergy symptoms. Into a glass warm milk you need to add ¼ tsp. soda Drink healthy drink recommended 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. Ready product must be strained. The infusion should be consumed ½ glass three times a day until the swelling completely disappears.

Video

Quincke's edema is usually defined as allergic condition, expressed in its rather acute manifestations. It is characterized by the occurrence of severe swelling of the skin and mucous membranes. Somewhat less often this state manifests itself in joints, internal organs and meninges. As a rule, Quincke's edema, the symptoms of which can appear in almost any person, occurs in patients suffering from allergies.

Main features of the disease

Considering the fact that allergy, as we have already noted, is a determining factor for predisposition to angioedema, it would not be amiss to consider the mechanism of its action, which will allow us to get a general picture of the disease. An allergy in particular is a hypersensitive reaction on the part of the body to certain irritants (allergens). These include:

• Plant pollen;
• Dust;
• Certain foods (oranges, strawberries, milk, chocolate, seafood);
• Medicines;
• Down, feathers and pet hair.

Directly allergic reactions exist in two varieties: reactions immediate type and delayed reactions. As for Quincke's edema, it acts as an immediate form of such a reaction, and is extremely dangerous. Thus, the body, when an allergen enters its environment, begins to produce a significant amount of histamine. As a rule, histamine in it is in an inactive state and its release occurs exclusively in conditions of a pathological nature. It is the release of histamine that provokes swelling while simultaneously thickening the blood.

When considering indirect factors that contribute to the emergence of a predisposition to a condition such as Quincke's edema, the following types can be distinguished:

Angioedema, depending on the nature of its occurrence, is of two types: allergic and pseudoallergic.

• Allergic Quincke's edema. This type of edema manifests itself in the form of a specific response from the body that occurs when it interacts with an allergen. More often allergic edema manifests itself in the case of food allergies.
• Non-allergic Quincke's edema. In this case, the formation of edema is relevant among those people who have a congenital pathology formed in the complement system (a protein complex that has fresh whey blood) transmitted to children from parents. The complement system due to own characteristics, is responsible for ensuring the body's immune defense. When an allergen enters the body, proteins are activated, after which humoral regulation is carried out to eliminate the irritant by protective mechanisms.

Violation of the complement system determines the spontaneous activation of proteins, which becomes the body’s response to certain stimuli (chemical, thermal or physical). The result is the development of a massive allergic reaction.

In the case of exacerbation of Quincke's edema and its non-allergic symptoms, edematous changes occur in the skin, as well as in the mucous membranes of the respiratory tract, intestines and stomach. Spontaneity of exacerbation of pseudoallergic edema can be provoked by factors such as temperature changes, trauma or emotional experiences. Meanwhile, in a third of cases resulting in angioedema, the cause of this reaction is unexplained. For other cases, the cause of its occurrence can be explained by drug or food allergies, bloodstream diseases and insect bites, as well as autoimmune diseases.

Quincke's edema: symptoms

As can be understood from the name itself, Quincke's edema is characterized by the occurrence of acute swelling of the skin (mucous membranes or subcutaneous tissue). Its most common manifestation is swelling of the facial tissue of the skin, as well as the feet and dorsum of the hands. As for pain, it is usually absent.

In the area where edema occurs, the skin becomes pale, while it itself can change its localization to one or another part of the body. The swelling is characterized by the density of the formation, which, when pressed with a finger, does not form a characteristic pit. In most cases, Quincke's edema is combined with a disease such as. In this situation, purple itchy spots with clearly defined shapes appear on the body, and they can merge with each other, forming a solid spot. When discussing urticaria, it should be noted that although this disease is unpleasant in itself, it does not pose a danger to life. It, in fact, acts as edema, characteristic of the upper layers of the skin.

This form of the disease is swelling of the pharynx, larynx or trachea is extremely dangerous, and it occurs in 25% of cases. The following symptoms are characteristic of laryngeal edema:

• Difficulty in breathing;
• Anxiety;
• The appearance of a “barking” cough;
• Hoarseness of voice;
• A characteristic blue discoloration that appears on the skin of the face, followed by pallor;
• Loss of consciousness (in some situations).

During an examination of the mucous membrane of the throat with these types of angioedema, the symptoms are characterized by swelling that forms in the palate and palatine arches, and a narrowing in the lumen of the pharynx is also observed. At further dissemination edema (to the trachea and larynx), the next condition is asphyxia, that is, attacks of suffocation, which, in the absence of medical assistance, can lead to death.

Concerning swelling of internal organs, then it manifests itself in the following states:

• Severe pain in the abdominal area;
• Vomit;
• Diarrhea;
• Tingling of the palate and tongue (if swelling is localized in the intestines or stomach).

In these cases, changes in the skin, as well as visible mucous membranes, can be excluded, which can significantly complicate the timely diagnosis of the disease.

It is also impossible to exclude from consideration such a type of Quincke's edema as swelling in the area of ​​the meninges, although it is quite rare. Among its main symptoms are the following:

• Lethargy, lethargy;
• Rigidity characteristic of the muscles of the back of the head (in in this case when tilting the head, the patient is unable to touch the chest with the chin);
• Nausea;
• Convulsions (in some cases).

Edema of various locations has the following common symptoms:

• Lethargy or agitation;
• Joint pain;
• Fever.

Based on associated factors and general conditions, angioedema has the following classification:

• Acute edema (illness duration is up to 6 weeks);
• Chronic edema (illness lasts longer than 6 weeks);
• Acquired edema;
• Edema caused by hereditary causes;
• Swelling with urticaria;
• Edema isolated from any type of condition.

Diagnosis of Quincke's edema

An extremely important component in diagnosing the disease is determining the factors that provoke it. For example, this could be a consideration of the possible connection of this condition with the use of certain foods, medications, etc. Such a connection can also be confirmed by taking appropriate allergy tests or by identifying a specific type of immunoglobulin in the blood.

In parallel with allergy tests, an assessment is also carried out. Additionally, a sample is taken to analyze various elements in the complement system, and stool analysis for helminths and protozoa. Are being considered for possible exception autoimmune diseases, as well as blood and intestinal diseases.

Quincke's edema: elimination of symptoms and treatment

The focus of therapy in this case is aimed at suppressing current allergic reactions. Severe cases in which relief of urticaria is not possible include injections of dexamethasone, prednisone and hydrocortisone. In addition, the doctor prescribes:

• Drugs antihistamine action;
• Enzyme preparations aimed at suppressing sensitivity to the action of an allergen;
• Hypoallergenic dietary food with the exclusion of citrus fruits, chocolate, coffee, alcohol, as well as spicy food from the diet.

In addition, therapy is also carried out, which involves the sanitation of each of the areas with chronic infection. The release of histamine in the presence of an allergen in the body is facilitated by bacteria.

In the case of treating edema due to its hereditary genesis, the doctor determines replenishing therapy for the patient. With its help, the lack of C1 inhibitors in the body is subsequently corrected.

Quincke's edema can occur in any person, but people who suffer from allergies are most susceptible to it.

Allergy - this is a hypersensitive reaction of the body to certain stimuli ( allergens).
Such irritants are:

• House dust.
• Plant pollen.
• Some food products: chocolate, milk, seafood, strawberry, orange.
• Some medications.
• Wool, feathers, down of pets.

Non-allergic Quincke's edema is formed by people who have a congenital pathology of the complement system, which is transmitted from parents to children. The complement system is a group of proteins in the blood that is responsible for immune protection body. Proteins are activated when an allergen enters the body, and defense mechanisms begin humoral regulation to eliminate the irritant.

In people with an impaired complement system, protein activation occurs spontaneously, as the body's response to chemical, physical or thermal stimuli. As a result, a massive allergic reaction develops.

Exacerbations of non-allergic Quincke's edema are manifested by edematous changes in the skin and mucous membranes of the stomach, intestines, and respiratory tract.

Spontaneous exacerbation of pseudoallergic edema can be provoked by a sharp change in temperature, emotional experiences, or trauma.

In a third of all cases of Quincke's edema, the cause of this reaction of the body cannot be determined. In other cases, the cause of edema is food or drug allergy, insect bites, bloodstream diseases, autoimmune diseases.

Symptoms of Quincke's edema

A dangerous form of the disease is swelling of the larynx, pharynx, and trachea, which occurs in 25% of patients. Laryngeal edema is accompanied by the following symptoms:

• Anxiety.
• Difficulty breathing.
• Barking cough.
• Hoarseness of voice.
• Blueness of the facial skin, then pallor.
• In some cases, loss of consciousness.

When swelling of the internal organs occurs, it is externally manifested by severe abdominal pain, diarrhea, and vomiting. When the swelling is localized in the stomach or intestines, the first sign is tingling of the tongue and palate.

Edema of the meninges is rare.
Its symptoms:

• Lethargy and lethargy.
• Rigidity of the neck muscles ( I can’t touch my chin to my chest when I tilt my head).
• In some cases - convulsions.

General symptoms of edema of different localizations:

• Fever.
• Excitement or lethargy.

Classification of Quincke's edema

• Acute edema.
• Chronic edema.
• Edema due to hereditary causes.
• Acquired edema.
• Edema isolated from other conditions.
• Edema combined with urticaria.

Diagnosis of Quincke's edema

• Has anyone in the family had allergies? Did they have an allergic reaction to the administration of vaccines?
• Has the patient had allergies before? If so, were there any signs of seasonal allergies?
• Are there any animals in the house?
• What is your eating style, what foods and dishes are most often consumed.

At allergic factor a history of edema; there are frequent allergic reactions in relatives; there are disorders of the digestive system. In such patients, when conducting allergy tests, the results are positive.

IN acute period diseases are carried out laboratory methods diagnostics, for example, determination of immunoglobulin E in blood serum.

During the period of remission, allergy tests are performed. The essence of the tests is that a small amount of a possible allergen is administered via intradermal injection; or through a scarification test - through microscopic punctures with a needle in the skin. In some cases, moisten a tampon in an allergen solution and apply it to the skin area ( application method).

The test is carried out using 10 - 15 types of allergens. If after a certain time the injection, scratch or application site turns red, it means the result for this particular allergen is positive. Depending on the presence and intensity of redness, 4 results are distinguished: negative, doubtful, weakly positive And positive.

However skin tests in some cases they have contraindications, this must be remembered:

• Exacerbation of chronic infections.
• Acute respiratory disease (ARI).
• Hormone therapy being taken.
• Age restrictions ( not older than 60 years).

Emergency care for acute angioedema

Waiting for him to arrive" Ambulance“, it is necessary to lay the patient down and raise his legs, open the window. In cases where the cause of edema is obvious ( bee sting or medication injection) – apply ice to this area to reduce itching.

If the bite or injection was made into the arm, then bandage it with a tourniquet above the site of the lesion. If you are stung by a bee, remove the sting as soon as possible.

Give drinking plenty of fluids; let the sorbents take in ( Enterosgel, Sorbex, or activated carbon). The sorbent will help quickly remove the allergen from the body. Place vasoconstrictor drops into the nose ( for example, naphthyzin).

If possible, you need to give an injection of an antihistamine: diphenhydramine, Claritin or others. If only antihistamine tablets are at hand, then they should be given under the patient’s tongue.

Adrenaline, prednisolone or hydrocortisone are injected under the skin. If swelling does not occur for the first time, then prednisolone should be carried with you at all times.

Treatment of Quincke's edema

• Antihistamines.
• Enzyme preparations to reduce sensitivity to allergen.
• Hypoallergenic dietary food (exclusion from the diet of coffee, chocolate, citruses, alcohol, spicy foods).

When treating edema of hereditary origin, replenishing therapy is prescribed, which corrects the deficiency of certain substances in the body ( C1 inhibitors)

When treating the idiopathic form with an unknown allergen, antihistamines prolonged action. However, they only help relieve external manifestations, but do not affect the cause of the disease, and therefore are not a complete treatment.

Prevention of Quincke's edema

• Carry out regular cleaning and wet cleaning.
• Glaze the shelves with books so that dust settling on the paper does not accumulate.
• Replace down and feather pillows with pillows with hypoallergenic synthetic filling.
• Use hypoallergenic cosmetics; Before first use, test for reaction: apply cosmetic product smear on the inner surface of the elbow and wait 15 minutes; If there is redness, do not use the product.
• It is advisable not to wear synthetic clothing.
• Children should not be allowed to play in bright colors plastic toys (they may contain allergens and toxic substances).
• When carrying out any medical procedures with a doctor, warn about a possible positive allergic reaction.
• If an allergy manifests itself to pet fur, it is necessary to limit contact with animals on the street, at guests, etc. as much as possible.
• Following a diet will help prevent the allergen from entering food.
• During flowering of plants, antihistamines should be taken preventively.