Quincke's edema: symptoms and treatment, photo, first aid
Edema Quinck called swelling of the skin or mucous membranes along with the underlying tissues, developing in response to ingestion of an allergen, that is, a substance that in a given person causes the release of an increased amount of histamine into the vessels.
This pathology develops most often on the face, neck or upper half of the trunk, less often - on the feet and hands. Suffer more often people of young age, most of whom are women.
There are two main types of edema Quincke:
1) Allergic. It is based on the isolation in response to the ingestion of an allergen of chemicals that cause expansion and increase in the permeability of small-caliber vessels. As a result, the liquid part of the blood passes through the vascular wall and enters the tissues. The distance between the cells increases - the tissues increase in volume, which has the form of edema.
Any substance can become the cause of this kind of edema Quincke:
With this mutation, complement is activated in any chemical, physical or mechanical stimuli, that is, the patient's face, neck, trunk or extremities can swell around in the face, in the cold or during heat, when a chemical enters the skin.
Also read the symptoms and treatment of hives.
In the case of Quincke's edema, the symptoms appear acute and sudden. For several minutes( sometimes - hours) after contact with the allergen( less often - after trauma, chemical ingestion or cold / heat release), edema appears on the face, trunk or extremities.
Lips, eyelids, tongue, soft palate, amygdala can locally swell. There may be edema of the scrotum or labia, the respiratory tract, the gastrointestinal tract and even the structures of the nervous system may suffer.
This swelling is painless, a person feels only the tension of the tissues at the place of his appearance. The skin in this place becomes dense, a little pale;when pressing on it fovea is not formed.
Edema can change localization, it can spread. Sometimes, when it comes to its allergic type, the urticaria is also a urticaria - the appearance on the skin of red, irregularly shaped spots, usually itchy, protruding above the surface of the skin and pale when pressed on them with glass.
With the development of edema on the lips, neck or tongue speech is difficult, it becomes difficult to breathe, the tongue becomes bluish. If the mucous membrane of the trachea, larynx or pharynx is swollen due to the disease, the following symptoms develop:
If an increase in the volume of mucous membranes or skin develops on a small area in contact with an allergen or a physical, chemical or mechanical irritant, an ambulance is required.
Before the brigade arrives, it is necessary:
In an acute period, only the determination in venous blood of immunoglobulin class E and factors of the complement system is possible. It also shows the performance of an immunogram - an analysis that will show malfunctions in the functioning of immunity in the acute period of the Quincke edema. With a non-allergic type of edema, general and biochemical blood tests are also performed.
During the remission with the help of a scarification test( allergoprob) determine what substance the organism of this particular person can respond with Quincke's edema. Such tests are carried out only in the conditions of a medical institution. The method of investigation is as follows: small scratches are made on the skin of the forearm, then dissolved allergens are applied there.
Evaluate the severity and volume of redness that occurs at the site of the allergen( for example, the liquid in which ragweed pollen is dissolved).
Allergic tests are not performed if:
edema treatment Emergency Quincke edema therapy is performed immediately upon admission to hospital. For effective treatment is used:
The diet is expanding, but potentially allergenic foods and alcohol remain excluded for a long time. It is also recommended to avoid at least about a month of hypothermia and overheating, stressful situations.
Complications of Quincke's edema may include:
To prevent the swelling of Quincke, a person should avoid contact with potentially allergic substances:
This pathology develops most often on the face, neck or upper half of the trunk, less often - on the feet and hands. Suffer more often people of young age, most of whom are women.
The causes of edema Quincke
There are two main types of edema Quincke:
1) Allergic. It is based on the isolation in response to the ingestion of an allergen of chemicals that cause expansion and increase in the permeability of small-caliber vessels. As a result, the liquid part of the blood passes through the vascular wall and enters the tissues. The distance between the cells increases - the tissues increase in volume, which has the form of edema.
Any substance can become the cause of this kind of edema Quincke:
- any food product to which only this person has intolerance. Most often these are products containing cocoa, seafood, nuts, red vegetables, fruits and berries, citrus fruits and dairy products;
- household chemicals;
- pollen of plants( see causes of bloom allergy);
- perfumery;
- medications;
- animal feed;
- insect bite;
- down, feather, wool of animals and birds, on which their saliva or excrement falls.
With this mutation, complement is activated in any chemical, physical or mechanical stimuli, that is, the patient's face, neck, trunk or extremities can swell around in the face, in the cold or during heat, when a chemical enters the skin.
Also read the symptoms and treatment of hives.
Symptoms of Quincke
In the case of Quincke's edema, the symptoms appear acute and sudden. For several minutes( sometimes - hours) after contact with the allergen( less often - after trauma, chemical ingestion or cold / heat release), edema appears on the face, trunk or extremities.
Lips, eyelids, tongue, soft palate, amygdala can locally swell. There may be edema of the scrotum or labia, the respiratory tract, the gastrointestinal tract and even the structures of the nervous system may suffer.
This swelling is painless, a person feels only the tension of the tissues at the place of his appearance. The skin in this place becomes dense, a little pale;when pressing on it fovea is not formed.
Edema can change localization, it can spread. Sometimes, when it comes to its allergic type, the urticaria is also a urticaria - the appearance on the skin of red, irregularly shaped spots, usually itchy, protruding above the surface of the skin and pale when pressed on them with glass.
With the development of edema on the lips, neck or tongue speech is difficult, it becomes difficult to breathe, the tongue becomes bluish. If the mucous membrane of the trachea, larynx or pharynx is swollen due to the disease, the following symptoms develop:
- a hoarse voice;
- inspiratory difficulty;
- barking cough;
- fear;
- further develops suffocation, loss of consciousness.
- abdominal pain;
- vomiting;
- tingling in the area of the tongue of the palate;
- diarrhea.
- drowsiness, retardation;
- nausea;
- sometimes - cramps with loss of consciousness;
- inability to reach the sternum in the supine position with the chin.
First aid for edema Quincke
If an increase in the volume of mucous membranes or skin develops on a small area in contact with an allergen or a physical, chemical or mechanical irritant, an ambulance is required.
Before the brigade arrives, it is necessary:
- to stop the exposure of the allergen;
- free from tight clothing, belt;
- ensure a good supply of fresh air;
- to lay with the raised head end;
- if swelling occurs after an insect bite, you need to apply a tourniquet( if it's limb) above the bite site;
- apply a cold compress to the place of edema;
- provide copious drinking;
- in the nose to drip vasoconstrictive drops( "Galazolin", "Nazivin", "Vibrocil", "Nazol" and others);
- give an antihistamine drug( Fenistil, Diazolin, Suprastin, Tavegil, Erius);
- one hour after taking antihistamine means to drink "Activated Carbon", "Sect", "White Coal";
- if a person carries a hormonal drug( "Dexamethasone", "Prednisolone" or another), help him to enter or drink it.
Diagnosis
In an acute period, only the determination in venous blood of immunoglobulin class E and factors of the complement system is possible. It also shows the performance of an immunogram - an analysis that will show malfunctions in the functioning of immunity in the acute period of the Quincke edema. With a non-allergic type of edema, general and biochemical blood tests are also performed.
During the remission with the help of a scarification test( allergoprob) determine what substance the organism of this particular person can respond with Quincke's edema. Such tests are carried out only in the conditions of a medical institution. The method of investigation is as follows: small scratches are made on the skin of the forearm, then dissolved allergens are applied there.
Evaluate the severity and volume of redness that occurs at the site of the allergen( for example, the liquid in which ragweed pollen is dissolved).
Allergic tests are not performed if:
- a person takes hormonal preparations( "Prednisolone", "Dexamethasone");
- during ARI;
- there was an exacerbation of a chronic disease;
- person less than 3 or more than 60 years.
Quinck
edema treatment Emergency Quincke edema therapy is performed immediately upon admission to hospital. For effective treatment is used:
- 1) Oxygen therapy through a mask, nasal catheters or an artificial ventilation device;
- 2) Hormone therapy( "Prednisolone", "Dexamethasone");
- 3) Introduction of injection antihistamines( "Suprastin", "Dimedrol", "Tavegil");
- 4) Introduction to the vein of solutions of sodium chloride, Ringer, Phillips, glucose, the drug "Reosorbilact";
- 5) Desensitizing therapy: administration of solutions( "Sodium thiosulfate", "Calcium chloride");
- 6) Inside give sorbents( "Activated charcoal", "Atoxil"), wash the stomach, put enemas;
- 7) After drip in a vein of solutions, the patient is given diuretics;
- 8) If necessary, the body is cleansed of toxins with the help of entero- or hemosorption, plasmapheresis;
- 9) For the entire acute period, compulsory adherence to a strict hypoallergenic diet is mandatory.
The diet is expanding, but potentially allergenic foods and alcohol remain excluded for a long time. It is also recommended to avoid at least about a month of hypothermia and overheating, stressful situations.
Complications of
Complications of Quincke's edema may include:
- respiratory failure;
- cystitis with the development of acute urinary retention( due to edema of the urinary tract);
- abdominal pain, symptoms of an acute abdomen, which sometimes results in unnecessary surgical intervention;
- swelling of the meninges, which can even lead to death.
Prophylaxis of Acute Quincke
To prevent the swelling of Quincke, a person should avoid contact with potentially allergic substances:
- to wipe the dust in the apartment;
- conduct wet cleaning;
- ventilate the room;
- not use feather pillows and feather beds;
- use fresh, not dry pet food;
- to process clothes with repellents before walking in the forest, on the meadow;
- use hypoallergenic cosmetics and household chemicals;
- if an allergy causes saliva in pets, discard their contents;
- observe a hypoallergenic diet;
- , when blooming allergenic plants, take antihistamines;
- cure all sources of chronic infection( teeth, tonsils, paranasal sinuses);
- is quenched, as with the development of ARI edema in predisposed individuals can develop from a weaker allergen;
- if Quincke's edema has developed at least once, a person with him should have an antihistamine, as well as ampoules of Prednisolone and Adrenaline together with syringes.