home Diseases How does angioedema develop in allergies? Quincke's edema - emergency measures, further treatment and prevention

How does angioedema develop in allergies? Quincke's edema - emergency measures, further treatment and prevention

Quincke's edema called acute allergic condition, which is characterized by swelling of the skin, mucous membranes, less often - internal organs, joints, meninges. IN medical literature sometimes called angioedema giant urticaria, or angioedema shock.

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.

Allergic reactions come in two types: immediate and delayed.
Angioedema is an immediate form of allergic reaction and is very dangerous disease. When an allergen gets inside, the body begins to produce a large number of histamine. Histamine is usually in an inactive state and is only released when pathological conditions. The released histamine causes edema tissues, thickens the blood.

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 combination of proteins in the blood that is responsible for the body's immune defense. The 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, 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 allergies, insect bites, bloodstream diseases, and autoimmune diseases.

Symptoms of Quincke's edema

Sudden swelling of the face ( lips, nose, eyelids), neck, back of the foot and palm, genitals. As a rule, there is no pain. The skin in the area of edema is pale. Edema can “move” across the surface of the body. The swelling is dense to the touch; if you press with your finger, a hole does not form. Most often, swelling is combined with urticaria. Clearly defined itchy purple spots form on the body. The spots can merge into one big spot. Hives itself is unpleasant, but not life-threatening. This is essentially swelling of the upper layers of the skin.

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 examining the mucous membrane of the throat in these cases, swelling of the palatine arches and palate is observed, as well as a narrowing of the lumen of the pharynx. If the swelling spreads further, to the trachea and larynx, then a state of asphyxia - suffocation - may occur. If medical assistance is not provided in time, the victim may die.

When swelling of internal organs occurs, it manifests itself externally severe pain in the abdomen, diarrhea, 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 edema of different localization:

Fever.
Excitement or lethargy.

Classification of Quincke's edema

Diagnosis of Quincke's edema

When a patient with edema goes to the doctor, the first thing the doctor does is stop the manifestations of edema. In the future, when determining the causes of the disease and thinking through the treatment strategy, the doctor is guided by the following anamnesis data:

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.

Carrying out differential diagnosis between edema of an allergic or pseudoallergic type and hereditary disease, the doctor must find out whether there was any edema in childhood. At hereditary form swelling occurs in close relatives different generations; as a rule, it is not accompanied by urticaria. Edema is provoked by minor microtrauma, stress or surgery.

At allergic factor history of edema, frequent allergic reactions in relatives, disorders 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 introduced through 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(ORZ).
Hormone therapy being taken.
Age restrictions ( not older than 60 years).

For non-allergic type of edema, a general examination is carried out, which includes bacteriological tests, biochemical and general blood tests, etc.

Emergency care for acute angioedema

Acute edema is emergency; First aid will help save the patient’s life.

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

Therapy is aimed at suppressing allergic reactions. In severe cases, when urticaria cannot be stopped, it is administered by injection. prednisolone, dexamethasone, hydrocortisone.
The doctor prescribes:

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

Therapy is carried out aimed at sanitizing all areas of chronic infection. Bacteria, in the presence of an allergen in the body, promote the release of histamine.

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, long-acting antihistamines are prescribed. 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

To exclude the manifestation of allergies and the often associated angioedema, you need to:

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 inner surface 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 with bright 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.

Quincke's edema is an immediate allergic reaction that is life-threatening. It develops acutely in response to external and internal stimuli. Approximately 10 percent of people in the world have experienced this type of allergy at least once in their lives.

A little about the reaction itself

This disease is characterized by local edema, which affects subcutaneous fat and mucous membranes both locally and limitedly. The condition is developing rapidly. In medicine, it may be called angioedema or giant urticaria. According to the ICD-10 classification, the pathology has code T78.3.

This acute condition, caused by the body’s individual reaction to external or internal stimuli, is most typical for individuals young, mostly women. And as we know from these statistics, modern children are increasingly being exposed to pathology, that is, the disease has a tendency to rejuvenate.

Quincke's edema develops according to the principle of allergies. However, in this case the vascular component is most pronounced. The pathological process is formed acutely with an antigen-antibody reaction, and inflammatory mediators primarily exert Negative influence on nerve fibers and blood vessels, causing disorders of their functions.

As a result, a rapid expansion of the circulatory network occurs and its permeability increases. Plasma penetrates into the intercellular space, thereby forming local swelling of nearby tissues. Cells affected by this pathological process paralyze the nerve trunks. The vessels cannot achieve full tone, relaxing more.

Most patients experience a combination of urticaria and edema.

Causes

The development of the condition may be preceded by the following factors based on an acute allergic reaction:

In 30 percent of cases the real reason Quincke's edema cannot be determined.

Classification

Taking into account the clinical manifestations and the presence of associated factors, angioedema is classified into the following types marked in the table.

Experts distinguish two types of angioedema, which occur with similar external symptoms:

angioedema;
hereditary angioedema (doctors do not classify it as angioedema, considering it a separate pseudo-allergic disease).

Symptoms

As mentioned above, the condition develops suddenly, literally in a few minutes. Only in some cases does it take more than one hour for clinical manifestations of the pathological process. Allergy is accentuated in tissues with developed fatty tissue and is accompanied by the following signs noted in the table.

Swelling of organs and systems	Characteristic
RESPIRATORY SYSTEM	Mainly affects the larynx. A barking cough and hoarseness occur. The skin turns bluish. Less often, a person loses consciousness.
FACE	Has a local character, in pathological process are involved different areas faces - lips, cheeks, eyelids.
GINOROGENITAL SYSTEM	The patient complains of symptoms of cystitis and problems with urination.
ORAL CAVITY	The condition is based on the spread of edema to the area of the tongue, tonsils and palate.
BRAIN	Pathology is characterized nervous disorders, for example, convulsions, loss of consciousness, etc.
GASTROINTESTINAL TRACT	Starts suddenly with symptoms acute abdomen, nausea, diarrhea. Signs of peritonitis develop less frequently.

As a rule, Quincke's edema in the vast majority of patients is localized in the area lower lip(pictured) spreads to the larynx, which causes acute respiratory distress. Often threatens with asphyxia. Condition requires emergency care, since the pathological process then moves to the membranes of the brain, and this is fraught with the death of the victim.

First aid

Quincke's edema develops so quickly that its unpredictability can lead to sad results. A person needs urgent medical care, so the first thing to do is call an ambulance.

What to do before the ambulance arrives?

Help for the victim at home is carried out as follows:

If we are talking about Quincke's edema, which is severe in terms of symptoms, then it is better not to engage in amateur activities and wait medical care. This is necessary in order not to provoke deterioration.

The nursing process includes the following aspects:

assistance in adoption comfortable position patient;
unbuttoning clothing in the area chest to ensure full access of oxygen;
calling specialists;
injection of Suprastin;
performing tracheotomy for in serious condition sick.

Actions after the ambulance arrives

The goals of emergency care are:

Then vasopressor amines are prescribed, for example, Dopamine at a dosage of 400 mg per 500 ml of glucose infusion. The volume of the listed medications is adjusted until stabilization systolic pressure 90 mmHg Art.

If bradycardia develops, Atropine 0.5 mg is injected subcutaneously.

The occurrence of bronchospasm is eliminated with antagonists and bronchodilators through a nebulizer.

Cyanosis, wheezing and dyspnea require oxygen therapy. Less commonly used are catecholamines, such as ephedrine.

What to do if laryngeal edema develops rapidly?

In this case, there is a high risk of complete closure of the airways and asphyxia, and drug therapy may not always give the desired effect. In such a situation, tracheotomy and further transportation of the patient to the intensive care unit are necessary.

Diagnostics

First of all, the specialist examines the patient to familiarize himself with the existing signs of the disease. In addition, attention is focused on how angioedema reacts to the injection of Adrenaline.

Next, the specialist finds out the cause of the current pathology. Usually, a simple questioning of the patient about his contact with potential allergens is sufficient for this. Allergy tests and specific blood tests are prescribed less frequently.

Treatment

Therapeutic measures aimed at combating angioedema include two stages: stopping the acute pathological process and eliminating its causes. After rendering emergency assistance the patient is sent to the hospital.

The choice of department is determined by the severity of the disease. In a complex condition, for example, with swelling of the larynx, the patient is taken to intensive care. At abdominal syndrome the patient is hospitalized in the surgical ward. If there is no threat to life, then the victim is sent to the therapeutic or allergy department.

The treatment process directly depends on the nature of the disease. A prerequisite is the complete exclusion of the patient’s contact with the allergen; for this, specialists reliably identify to which product or substance a person has individual hypersensitivity.

At the time of therapeutic measures, a hypoallergenic diet is prescribed, excluding honey, berries, chocolate and other products that can become potential irritants.

The patient is prescribed antihistamines - Suprastin, Citrine, etc. As a rule, the course of taking them is from 7 to 10 days.

Traditional treatment

Alternative medicine can facilitate and speed up the recovery process for angioedema. Let us list which recipes may be useful for the patient.

Quincke's edema in children

IN childhood Angioedema is a common condition accompanying allergies. But the pathological process itself occurs with its own characteristics.

First of all, it reaches vast volumes. Secondly, it has a migratory nature. Thirdly, it has a fairly dense and uniform structure. About half of the cases are accompanied by urticaria.

The most dangerous thing for young patients is swelling of the throat and larynx. Since the pathological process occurs rapidly, parents should urgently seek emergency help at the slightest suspicion of the disease.

Children prone to allergies require special attention. Causes of pathology at an early age:

Dr. Komarovsky advises all parents not to resort to independent diagnosis and treatment, but to seek medical help in a timely manner, preventing complications in the child.

Quincke's edema in pregnant women

While carrying a baby, a woman's sensitivity to allergens changes - it becomes several times stronger, so the development of angioedema is by no means uncommon. Expectant mothers are at greatest risk in the second trimester. An allergy can manifest itself completely unexpectedly to those medications and products that a woman previously tolerated without any consequences.

In pregnant women, Quincke's edema is often accompanied by serious complications: giant urticaria, stomach cramps, hypertensive crisis, proteinuria in the urine.

Any of the listed conditions has bad influence on the growth and development of the unborn child, the health and even the life of the mother. Majority medicines, used in the treatment of angioedema, are contraindicated in pregnant women. Therefore, self-medication is out of the question. At the slightest sign pathology, it is mandatory to call an ambulance.

How long does the reaction last?

Classic edema of an uncomplicated nature. It occurs from several days to one week. If the pathological process has not affected the vital important organs, the condition passes without a trace.

Swelling affecting the larynx. Lasts from 3 days to several weeks. The disease requires urgent help, otherwise it provides the basis for development chronic pathologies respiratory system in future.

Swelling of the gastrointestinal tract. On average it lasts one week. Approximately on the eighth day, the patient’s condition stabilizes, nutrition and functioning of the digestive organs are restored.

Damage to the urogenital system. Observed for 2 to 4 days. In case of complications, the duration of the illness increases to one week.

Swelling of the face. It is the most dangerous and long-lasting condition, as the meninges can be affected. The disease lasts up to 6 weeks, but with timely treatment medical care the condition disappears in 10 days.

With absolute visual well-being, Quincke's edema is observed in inpatient conditions at least within 24 hours. Further, the length of hospitalization directly depends on the patient’s well-being and the therapeutic care he needs.

Diet

A person who has had angioedema once should continue to adhere to strict rules nutrition. Failure to comply with them may cause a relapse of the disease.

Immediately after an attack, the following foods are prohibited:

Allowed to include in the diet:

In the first days after Quincke's edema, doctors insist on starvation diet. New products are being introduced gradually.

Complications

Consequences that pose a threat to life are edema, which affects the mucous membrane of the larynx with an increase in suffocation associated with acute respiratory failure, as well as swelling of the meninges with symptoms of meningitis. The listed complications in most cases lead to the death of the patient.

With angioedema, regardless of its location, anaphylactic shock often develops - an extremely complex and dangerous reaction for life, affecting the functioning of the entire organism. Its main manifestations:

swelling of the oropharynx, larynx and tongue;
generalized itching;
hives;
bronchospasm, lacrimation;
nausea, vomiting, abdominal pain, diarrhea;
tachycardia, hypotension, arrhythmia, acute heart failure;
convulsions, asphyxia, coma.

Illiterate people lead to fatal complications, namely death. therapeutic actions from others and ambulance specialists.

Prognosis and prevention

The outcome of angioedema depends entirely on the severity of clinical manifestations and the list of therapeutic measures provided. For example, damage to the larynx ends in death if emergency care is not provided in 100% of cases. Hereditary angioedema occurs periodically throughout life, but competent prevention And correct treatment eliminate complications and reduce the risk of relapse to a minimum.

cure allergic edema In 2019, Quincke will be helped by a unique technology - autolymphocytotherapy. Long-term remission of the disease is achieved in 91% of patients.

This allergic disease was first described by the German neurologist Quincke in 1882.

Modern medicine distinguishes two of its different forms, similar only in appearance clinical manifestations: angioneurotic And allergic Quincke's edema. The identical clinical picture of these two diseases often leads to incorrect diagnosis and fatal complications. After all, treatment tactics and even provision intensive care The two types of swelling are very different!

Distinguish allergic form Quincke's edema from angioedema is possible only with the help of special studies.

Angioedema

Hereditary angioedema is angioedema chronic illness, belonging to the group of congenital immunodeficiencies. This form of edema is characterized by the presence of a genetically determined defect of the immune system, in which in most cases family inheritance can be traced.

Hereditary angioedema, in contrast to allergic angioedema, most often occurs in connection with injuries (bruises, compression by clothing, surgical interventions). Exacerbation of this form of the disease can also be provoked by the following factors: intense physical or psycho-emotional stress, hypothermia, infectious diseases, hormonal changes in the body: taking contraceptives, pregnancy.

Angioedema angioedema manifests itself as local edema skin, subcutaneous tissue or mucous membranes of the respiratory tract, gastrointestinal and urogenital tract. Wherein itchy skin, as a rule, is absent.

Hereditary angioedema is diagnosed by special laboratory research, which reveal a genetically determined defect of the immune system. Right established diagnosis diseases will prevent complications that are life-threatening for patients.

Main directions in the treatment of angioedema

When acute form diseases with swelling of the trachea, larynx, bronchi, urgent measures are taken to relieve the acute condition.

Symptomatic therapy is carried out after laboratory confirmation of the diagnosis and only under the supervision of specialists in a hospital setting. Corticosteroids, tranquilizers, sedatives, including immunomodulators, as well as 2nd and 3rd generation antihistamines.

Sports activities are strictly not recommended for patients with hereditary angioedema. work activity associated with increased risk of injury, physical effort, and mechanical pressure on the skin and subcutaneous tissue. Surgical interventions It is advisable for patients to undergo it in a hospital setting.

The treatment method “Autolymphocytotherapy” is not used for this form of the disease!

Allergic Quincke's edema and its manifestations in the patient

Allergic angioedema By external manifestations almost no different from the angioedema form of the disease. Its sign is clearly limited swelling of the skin and subcutaneous tissue, not accompanied by itching.

How do the symptoms appear?

Edema can occur in the face (swelling eyes, swollen nose and lips), extremities, as well as mucous membranes (oral cavity, larynx, tracheobronchial tree, gastrointestinal and urogenital tracts - even swelling of the genitals).

Quincke's edema localized in the face, lips, tongue is often accompanied by swelling of the larynx. This condition requires emergency first aid, as it threatens the patient’s life. Severe swelling in the throat area is accompanied by difficulty breathing, coughing and can lead to suffocation in an allergic person.

Unlike angioedema, its allergic variety is often accompanied by rashes in the form of urticaria. In this case, the following occurs: skin rash, severe itching and burning of the skin.

The allergic form of Quincke's edema is also called "giant urticaria", in fact it is extreme degree allergic reaction (along with anaphylactic shock). And adrenaline injections in severe cases of an allergic reaction are one of the forms of emergency care for the patient.

A little about the causes of the disease

Allergic Quincke's edema can be caused by food products, provoking the release of histamine by immune cells: fish, seafood, eggs, nuts, legumes, citrus fruits, tomatoes, eggplants, smoked products, chocolate, cheese, alcohol, confectionery with tartrazine dye. Therefore, for prevention, the patient must follow a hypoallergenic diet, excluding prohibited foods from the diet. Acute angioedema after eating allergens leads in the number of relapses among allergy patients.

Particular care should be taken in patients with seasonal rhinitis(hay fever) during the flowering period of plants, when allergic urticaria when eating fresh fruits can provoke Quincke's edema.

Therefore, if you experience frequent angioedema, then do not self-medicate at home! Be sure to get examined, take an allergen test and get an IgE test from an allergist at your nearest clinic.

Hypoallergenic diet, excluding the consumption of cause-significant allergenic foods;
Various medications, antihistamines and tablets (Suprastin, Kestin, Loratadine, Zyrtec, Erius, Ketotifen, etc.);
Hormonal ointments (Elocom, Advantan with prednisolone, etc.);
Folk remedies and homeopathy;
Grandmothers-healers.

They will not relieve you of the cause of the allergic disease, and best case scenario will only affect the symptoms of Quincke's edema.

A unique product will help you cure the cause of allergic angioedema and achieve long-term remission of the disease. medical technology- autolymphocytotherapy (ALT).

Problems of a patient with allergic edema

With the help of ALT, allergic angioedema is treated, which is caused by:

And they do not treat:

Get rid of angioedema using the ALT method in 2019!

"Autolymphocytotherapy" (abbreviated as ALT) is widely used in the treatment of patients with various forms allergic diseases for more than 20 years - the method was first patented in 1992.

ALT is used to treat angioedema in children and adults. For children, treatment with the Autolymphocytotherapy method is carried out after 5 years.

The “Autolymphocytotherapy” method, in addition to the treatment of “Quincke’s edema”, is widely used for: atopic dermatitis, hives, food allergies, bronchial asthma, allergic rhinitis, hay fever, food allergies, allergies to household allergens, allergies to pets, allergies to cold and ultraviolet rays (photodermatitis).

The essence of the ALT method is to use lymphocytes’ own immune cells to restore normal function immunity and reducing the body's sensitivity to various allergens.

The main advantage of ALT over ASIT therapy is the possibility simultaneous treatment several allergic diseases. For example, hay fever and Quincke's edema with polyvalent allergies to pollen and food allergens.

Autolymphocytotherapy is carried out on an outpatient basis, in an allergology office as prescribed and under the supervision of an allergist-immunologist. Lymphocytes are released from a small number venous blood patient under sterile laboratory conditions.

The isolated lymphocytes are injected subcutaneously into the lateral surface of the shoulder. Before each procedure, the patient is examined in order to individually prescribe the dose of the administered autovaccine. In addition to its own lymphocytes and physiological solution, the autovaccine does not contain any medicines. Treatment regimens and the number and frequency of immune cells administered depend on the severity of the disease. Autolymphocytes are administered in gradually increasing doses with an interval between injections of 2 to 6 days. The course of treatment consists of 6-8 procedures.

Normalization of the functions of the immune system and a decrease in the body's sensitivity to allergens occurs gradually. Extension hypoallergenic diet carried out within 1-2 months. Cancel support symptomatic therapy It is also carried out gradually under the supervision of an allergist. The patient is given the opportunity to have 3 free follow-up consultations within 6 months of observation after completing the course of treatment using the Autolymphocytotherapy method.

The effectiveness of treatment is determined individual characteristics immune system. This process to a certain extent depends on the patient’s compliance with the recommendations of the allergist during the period of treatment and rehabilitation.

WITH possible contraindications you can find it on our website.

Ask a question to a specialist

Quincke's edema is usually defined as an 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: immediate-type reactions and delayed-type 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. Most 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 congenital pathology, formed in the complement system (a protein complex found in fresh blood serum), transmitted to children from parents. The complement system, due to its own characteristics, is responsible for ensuring immune defense body. 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 appearance acute edema 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. With further spread of edema (to the trachea and larynx), the next condition becomes 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 this case, when tilting the head, the patient is unable to touch the chest with the chin);
Nausea;
Convulsions (in some cases).

Edema various localizations have 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 the corresponding allergy tests or when a specific type of immunoglobulin is detected 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. Possible exclusion of autoimmune diseases, as well as blood and intestinal diseases are being considered.

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, injections of dexamethasone, prednisone and hydrocortisone are prescribed. In addition, the doctor prescribes:

Drugs antihistamine action;
Enzyme preparations aimed at suppressing sensitivity to the action of an allergen;
Diet food hypoallergenic effect when excluding citrus fruits, chocolate, coffee, alcohol, and spicy foods 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 is a dangerous allergic reaction with severe symptoms. If first aid is provided incorrectly, the consequences can be very serious. Negative signs appear in the upper part of the body: the face, lips, neck swell, the lumen of the larynx often narrows, and there is a risk of suffocation. Some patients develop swelling of internal organs, which is life-threatening.

What allergens provoke an acute reaction? What to do during development angioedema? How to provide first aid for Quincke's edema? These and many other issues related to severe allergic reactions are covered in the article.

Causes of a severe allergic reaction

A dangerous condition develops under the influence of various types of irritants. in a quarter of cases occurs when hereditary predisposition To increased sensitization body, in some cases doctors cannot determine the exact cause of the acute immune response. Quincke's edema code according to ICD - 10 - T78.3.

Provoking factors and allergens:

products of certain groups. In most patients it causes severe allergic reaction certain types food: honey, eggs, whole milk, citrus fruits. Red berries, fruits and vegetables, chocolate, seafood, and peanuts are also highly allergenic;
household chemicals, washing powders, body care compositions;
potent medications: iodine-containing agents, sulfonamides, antibiotics, aspirin, B vitamins, compounds with an anticonvulsant effect;
plant pollen during the flowering period;
poison that enters the body through insect bites;
cosmetics, especially low-price products with irritating ingredients;
helminthic infestations;
feather, wool, fluff of pets. Excrement, saliva, particles of dead epidermis in animals are dangerous irritants, especially for children;
physical factors: light, low temperatures;
viral and bacterial infections;
dry food for fish and parrots;
frequent, prolonged stress;
severe autoimmune diseases.

Basic Rules:

parents should prepare the child’s diet taking into account the degree of allergenicity of the products;
You should not feed your children food that contains dangerous synthetic fillers, preservatives, or dyes;
It is advisable to protect children from contact with potential allergens, especially if the body is weak. Plant pollen, animal hair, some drugs, insect bites are the main irritants that provoke angioedema;
You need to strengthen your immune system, spend time in the air, and do hardening. Important point- warning passive smoking, worsening the general condition of household members, especially children;
There should always be antihistamines in your first aid kit. Giant urticaria develops quickly, often within 15-30 minutes. If you don't have a home, allergy medications are possible. severe consequences. Allergy sufferers should always carry an antihistamine prescribed by a doctor.

Every person should know the symptoms, consequences, causes of angioedema. If signs of giant urticaria appear, the participation of health care workers is required. Don't panic: Correctly provided first aid often saves the life of an adult or child with an acute allergic reaction.

In the next video useful tips a specialist on how to provide first aid for angioedema and what can be done before specialists arrive: