Angioedema (or Quincke's edema) is an acute reaction of an allergic nature that develops in response to exposure to various chemical or biological irritants. A similar condition was first described by the German doctor G. Quincke back in 1882. It manifests itself as instantly developing limited swelling of the skin, mucous membranes and subcutaneous fat. Quincke's edema is characterized by sudden development and most often affects the face, neck, upper body, and genital area. In this case, swelling can reach a maximum in just a few minutes and, if it spreads to the mucous membrane of the larynx, it can provoke a life-threatening condition such as suffocation.
Almost anyone can be at risk, but people who are prone to allergic reactions are more likely to experience angioedema. Moreover, children and women suffer from such manifestations much more often than men. The development of Quincke's edema is a dangerous condition with unpredictable consequences that requires emergency medical care. Delay can be fatal, so everyone needs to know about the main manifestations of the disease. Let's find out what provokes a dangerous condition and how to provide first aid when it develops.
Angioedema according to ICD 10 (International Classification of Diseases) is coded T78.3. Experts distinguish two types of Quincke's edema: allergic and pseudoallergic (hereditary). Accordingly, the reasons causing the dangerous condition are different. In the first case, edema develops as a response of the immune system to a specific allergen entering the body. At risk are people prone to food allergies and with concomitant diseases such as hay fever or bronchial asthma. Quite often, angioedema develops simultaneously with manifestations of urticaria. It is not easy to accurately determine the specific irritant, since the development of swelling can be caused by many provoking factors:
In some situations, angioedema can be triggered by external factors (intense solar radiation, cold).
Hereditary angioedema develops in individuals with congenital pathologies associated with C1 inhibitor deficiency and complement system disorders, due to which the body cannot control the release of inflammatory mediators. This type of disease most often affects men. The occurrence of a dangerous condition, often accompanied by swelling of the larynx, is provoked by stress and microtrauma. In addition, edema can develop under the influence of external irritants (temperature changes, strong physical activity). This condition is treated according to different principles than allergic edema.
Angioedema in young children is not common, but there are situations when a life-threatening condition develops even in infants. In children, edema can develop to very large sizes, and it can migrate and appear on the body in one place or another. In half of the cases, a combination of Quincke's edema and urticaria symptoms is observed.
Any organ can be affected, but most often swelling appears in the face, lips, eyelids, genitals, and the back of the arms and legs. In severe cases, swelling of the larynx and respiratory tract develops, and the damage spreads to the membranes of the brain and internal organs.
Common symptoms of angioedema are:
Depending on the location of the edema, specific symptoms appear:
Quincke's edema usually lasts for several hours, in rare cases it persists for a day, after which it disappears without a trace. A visual representation of what its manifestations look like is given by photos of angioedema . Once you see the characteristic symptoms of this acute allergic reaction, in the future it is no longer possible to make a mistake with the diagnosis, these phenomena are so specific. If alarming signs appear, you should immediately call emergency assistance, and before it arrives, be able to provide first aid to the victim.
At the first signs of breathing problems and the appearance of swelling, you should immediately call an ambulance. Before the medical team arrives, try to help the victim. It is important to try to stop contact with the allergen: for example, remove the sting from an insect bite, eliminate the drug, rinse the stomach if you have a food allergy. If the patient is suffocating, try to calm him down, unbutton the collar of his clothes, take him out into the fresh air or open the windows in the room to facilitate oxygen access. If swelling develops at the site of the insect bite, apply an ice pack to the site.
Give the patient something to drink. The more fluid enters the body, the faster toxins and allergens will come out. You can give mineral water (Borjomi), or a weak soda solution (1 g of baking soda per 1 liter of water). For the same purpose, you can give a sorbent (activated carbon, Polysorb). Try to have the victim swallow a tablet of any antihistamine (Claritin, Suprastin, Tavegil). If the victim loses consciousness, clear the airway, prevent the tongue from retracting, monitor the pulse, and perform artificial respiration.
Upon arrival of the ambulance team, the efforts of doctors will be aimed at restoring respiratory function and normalizing the victim’s blood pressure. For this purpose, Prednisolone and Adrenaline are infused intramuscularly. To reduce allergic manifestations, antihistamines (Suprastin, Diphenhydramine) are administered, or medications are given in the form of tablets or drops (Erius, Zyrtec). When the heart rate decreases, Atropine is used.
If laryngeal edema develops, a tracheostomy is performed. To do this, a tube is inserted into the windpipe through an incision, through which air enters. After the victim recovers from the life-threatening condition, he is sent to the hospital for further treatment.
Diagnostic methods are based on a thorough study of the patient’s medical history and complaints. The specialist must conduct a visual examination: measure the pressure, listen to the lungs, palpate the abdomen. Next, the patient is sent for tests. In the process of diagnostic measures, it is very important to determine the agent that provokes the development of edema. For this purpose, a general blood test is examined, the level of general and specific immunoglobulin is determined, and skin allergy tests are performed.
If a hereditary form of Quincke's edema is suspected, it is necessary to additionally examine the next of kin and donate blood to test the level of C1 protein. Competent diagnosis of the disease allows us to determine the nature of the disease (allergic or congenital) and select the correct treatment, taking into account the individual characteristics of the patient.
After an attack, the patient is taken to a hospital, where they undergo comprehensive treatment aimed at identifying and eliminating the provoking allergen, reducing the synthesis of inflammatory mediators and strengthening the body’s defenses. The treatment regimen includes the following drugs:
A special role in the treatment of acute allergic reactions is given to diet therapy. The patient's diet excludes all foods that can trigger allergies. During the acute period and for 2-3 days after it, the patient is recommended to fast, with a gradual transition, first to white crackers and water, then to oatmeal cooked in water. In the following days, exclude the following foods from the diet:
The menu includes lean dietary meat, lean fish, weak broths, porridges, fresh cucumber salad, cabbage seasoned with vegetable oil, crackers, and biscuits. It is recommended to drink more fluids. This can be pure drinking or still mineral water, green tea. An increased drinking regimen will help reduce intoxication in the body and speed up recovery.
Angioedema is an extremely dangerous and insidious condition that can result in coma and death in cases where the larynx and respiratory tract are affected. Therefore, be attentive to your condition, try to identify provoking factors and in the future avoid any contact with allergens.
In case of gastrointestinal lesions, accompanied by abdominal pain and vomiting, the patient may be subjected to unnecessary surgical intervention, since many acute conditions have similar symptoms (appendicitis, intestinal obstruction, etc.). This is another danger of an acute allergic reaction.
When edema spreads to the meninges and brain, the patient experiences neurological disorders (seizures, speech impairment, loss of voluntary movements). In cases where the genitourinary system is affected, acute cystitis may develop, accompanied by urinary retention.
It is possible to avoid attacks and the development of Quincke's edema only if contact with the allergen is completely excluded. If the provoking factor cannot be identified and eliminated, repeated attacks of acute allergic reactions are possible, which poses a serious threat to the health and life of the patient.
After the first acute attack and relief of dangerous symptoms, treatment is carried out in a hospital by a general practitioner. In the future, the patient should definitely consult with an allergist to identify the agent that provokes the attack. If necessary, the doctor will perform skin allergy tests to determine the allergen. If you avoid contact with it, then agioneurotic edema will not recur. An allergist can offer specific therapy, in which the introduction of minimal doses of the allergen over several months develops resistance, and the body no longer reacts so violently to contact with it.
An important preventative point is adherence to a hypoallergenic diet, proper and balanced nutrition, and adherence to a drinking regime. To strengthen the body's defenses, it is recommended to lead an active lifestyle, play sports, and walk more in the fresh air. But if you have allergic reactions to dust or flowering plants (hay fever) during a certain period, then at this time it is better to leave the city to another climatic zone, where there are no plants that provoke characteristic symptoms. If alarming signs appear, you should immediately take antihistamines recommended by your doctor and keep them always on hand.
With proper treatment of agnioneurotic edema and following the doctor’s recommendations, all visible symptoms disappear after a few days. In the future, be careful and do everything possible to avoid another attack.
Edema of the eyelids is a condition of excessive accumulation of fluid in the subcutaneous fat, which leads to swelling and swelling of the skin layer around the eyes. The loose structure of the subcutaneous fat layer and a large accumulation of blood vessels make the upper and lower eyelid area prone to swelling.
The most common causes of eyelid swelling are:
In the absence of an inflammatory process, the upper eyelid may swell due to the following pathologies:
Swelling in the lower eyelid area leads to swelling and the formation of “bags” under the eyes. Most often, such symptoms are more pronounced in the morning, are bilateral, are non-inflammatory in nature and can be caused by certain diseases, mechanical irritations or physiological structural features.
The causes of this pathology may be:
Swelling of the eyelids in the morning may appear occasionally or recur systematically.
Rare swelling may be signs of:
To relieve the condition in the morning, it is useful to apply a cold compress and take a diuretic.
Traditional cosmetics are applied to the surface layer of the skin. Using properly selected cosmetic products does not lead to inflammatory processes in the area around the eyes.
Damaged skin is an area open to infection, so after the tattoo procedure, the skin of the eyelids needs careful care - treatment with antibacterial and restorative agents, protection from ultraviolet rays. Swelling after tattooing on the eyelids can have various causes:
If the procedure is successfully performed, the swelling disappears within the first day. A longer period may indicate the presence of complications and the onset of the inflammatory process.
Swelling of the upper or lower eyelids is an alarming sign that requires immediate medical attention. In the early stages, many diseases may occur without other obvious symptoms. A qualified specialist and a general examination of the body’s condition will help identify possible diseases that provoke the appearance of edema. A diagnostic test must include:
Further studies may be ordered in connection with the suspected diagnosis, followed by appropriate treatment.
Effective treatment of edema requires comprehensive measures to eliminate the cause of its occurrence, as well as local procedures. To eliminate discomfort and stimulate rapid resorption of accumulated fluid, you can use the following methods:
Before using any product, the face and area around the eyes must be cleaned of cosmetics, the composition of the mask must be slightly warmed, and the procedures must be repeated 2-3 times a week. After use, rinse off the remaining mask with warm water and apply a light moisturizer.
It is equally important to provide complete care for the skin around the eyes, including:
A good prevention of lower edema is a light morning massage for 2–3 minutes. To do this, you should perform light tapping movements towards the temples and bridge of the nose. These are the directions of lymph outflow.
It is useful to carry out special gymnastics for the eyes (2-3 times a day):
For swelling of the eyelids of any nature and degree of manifestation, the following actions are strictly not recommended: