Quincke’s Edema: Symptoms and Treatment
It is customary for Quincke’s father to determine the allergic condition, expressed in rather acute manifestations. It is characterized by the appearance of severe swelling of the skin, as well as mucous membranes. This state is manifested more rarely in joints, internal organs and meninges. As a rule, Quincke’s edema, the symptoms of which can manifest in almost any person, occurs in patients with allergies.
Main features of the disease
Considering the fact that the allergy, as we have already noted, is the determining factor for the predisposition to the swelling of Quincke, it is not superfluous to consider the mechanism of its action, which will allow us to obtain a general picture of the disease. Allergy in particular is a hypersensitive reaction from the body towards certain irritants (allergens). These include:
- Pollen of plants;
- Certain foods (oranges, strawberries, milk, chocolate, seafood)
- Pooh, 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. So, the body, when it gets into its allergen environment, begins to produce a significant amount of histamine. As a rule, histamine in it is inactive and its release occurs exclusively in conditions of a pathological nature. It is the release of histamine and provokes swelling with simultaneous blood thickening.
When considering the indirect factors that contribute to the emergence of a predisposition to a condition such as Quincke’s edema, we can distinguish the following types:
- Diseases associated with the endocrine system
- Diseases related to internal organs
- Parasitic and viral forms of infections (giardiasis, hepatitis, and helminthic invasion)
Quincke Edema Types
Quincke’s edema, depending on the nature of the occurrence, is of two types: allergic and pseudoallergic.
- Quincke Allergic Edema. This type of edema manifests itself in the form of a specific response from the body that occurs when it interacts with the allergen. Most often, allergic edema appears in the case of food allergy
- In this case, the edema formation is actual among those people who have a congenital pathology, formed in the complement system (protein complex, which has fresh blood serum), transmitted to children from the parents. The complement system, due to its own characteristics, is responsible for ensuring the immune defense of the body. When the allergen enters the body, proteins are activated, after which humoral regulation is performed to remove the irritant by protective mechanisms.
Violation of the complement system determines spontaneity in the activation of proteins, which becomes the body’s response to certain stimuli (chemical, thermal or physical). As a result — the development of a massive allergic reaction.
In the case of exacerbation of Quincke’s edema and its symptoms of a non-allergic appearance, edematic changes in the skin, as well as mucous airways, intestines and stomach are formed. Spontaneity of exacerbation of pseudoallergic edema can be provoked by such factors as temperature change, trauma or emotional experiences. Meanwhile, a third of the cases that result in Quincke’s edema, the cause of this reaction is inexplicable. For other cases, the cause of its occurrence can be explained by drug or food allergies, blood-flow diseases and insect bites, as well as autoimmune diseases.
Quincke’s Edema: Symptoms
As can be understood from the name itself, the edema of Quincke is characterized by the onset of acute edema of the skin (mucous membranes or subcutaneous fat). The most frequent manifestation of this is the edema of the facial skin of the skin, as well as the feet and back surfaces of the hands. As for pain, it is usually absent.
In the area of the onset of swelling, the skin becomes pale, while he himself can change his own localization to this or that part of the body. The edema is characterized by the density of formation, which, when pressed with a finger, does not form a characteristic fossa. In most cases, angioedema is combined with a disease such as urticaria. In this situation, the body develops purple itchy spots with clearly defined shapes, while they can merge with one another, forming a solid spot. Arguing about urticaria, it should be noted that the disease is, although unpleasant in itself, but does not pose a danger to life in itself. It, in fact, acts as an edema characteristic of the upper skin layers.
This form of the disease, such as swallowing of the throat , larynx or trachea is extremely dangerous, and it occurs in 25% cases of morbidity. For the laryngeal edema, the following symptoms are typical:
- Breathing difficulty
- The emergence of a barking cough
- Harshness of voice
- Characteristic blueing that appears on the skin of the face, subsequent pallor
- Loss of consciousness (in some situations).
In the course of examining the mucous throat with these varieties of Quincke’s edema, the symptoms are characterized by swelling that forms in the palate and palatine arch, and a narrowing in the lumen of the zoona is also observed. With the further spread of edema (to the trachea and larynx), asphyxia becomes the next condition, that is, attacks of suffocation, which, if not provided, can lead to death.
As for edema of internal organs , it manifests itself in the following states:
- Severe abdominal pain
- Tingling of the palate and tongue (with localization of edema in the intestine or in the stomach).
In these cases, changes in the skin, as well as visible mucous membranes, can be excluded, which can greatly complicate the timely diagnosis of the disease.
We can not exclude from consideration such a kind of Quincke edema, as edema in the area of the brain envelopes , although it is rare enough. Among its main symptoms are the following:
- Lethargy, retardation;
- Stiffness, characteristic of the occiput muscles (in this case, when the head is tilted, the patient can not touch the chest with the chin)
- Seizures (in some cases).
Edema of different localization have the following common symptoms for them:
- Inactivity or excitement
- Joint pain
Based on concomitant factors and general conditions, Quincke’s edema has the following classification:
- Acute edema (duration of illness is up to 6 weeks);
- Chronic edema (illness lasts longer than 6 weeks);
- Acquired swelling
- Caused by hereditary causes of edema
- Swelling with hives
- Isolated from any type of conditions swelling.
Diagnosis of Quincke’s Edema
An extremely important component in the diagnosis of the disease is the identification of the factors that provoke it. For example, it may be a consideration of the possible connection of this state with the use of certain foods, medications, etc. Such a relationship can also be confirmed by taking appropriate allergic tests, or by detecting a specific type of immunoglobulin in the blood.
In parallel with the conduct of allergic tests, an evaluation of the general analysis of urine, blood, and biochemical constituents of blood is also conducted. Additionally, a sample is taken for analysis of various elements in the complement system, analysis of feces for helminths and protozoa. Consideration is being given to the possible exclusion of an autoimmune disease, as well as diseases of the blood and intestines.
Quincke’s Edema: Removing Symptoms and Treating
The focus of therapy in this case is focused on suppressing the actual allergic reactions. Severe cases in which relief of urticaria is not possible, involves the injection of dexamethasone, prednisalone and hydrocortisone. In addition, a doctor is appointed:
- Antihistamine drugs;
- Enzyme preparations that are aimed at suppressing sensitivity to the action of an allergen
- Dietary food of hypoallergenic action with the exclusion of citrus, chocolate, coffee, alcohol, as well as spicy food from the ration.
In addition, there is also a therapy, which provides for the sanation of each of the sites with chronic infection. The release of histamine in the event of an allergen in the body is promoted by bacteria.
In the case of the treatment of edema in hereditary genesis, the physician determines for the patient a replenishment therapy. With its help, there is a subsequent correction of the lack of C1-inhibitors in the body.
Treatment of an idiopathic form, in which the allergen has not been determined, prescribes antihistamines with prolonged action. They, however, can only eliminate external manifestations, without affecting the very cause of the disease, which determines the inferiority of this type of treatment.
To diagnose Quincke’s edema and determine subsequent treatment, you should consult a therapist or an allergist. If necessary, any of these specialists can additionally direct the patient to a dermatologist.