Quincke swelling (angioedema) – this is sharp
arising and not characterized by pain swelling deep
skin or mucous membranes. This is an allergic reaction.
manifested by an increase in the size of the face, neck, arms and legs of people in
any age. A dangerous consequence is the death of the patient.
The disease is presented and studied in 1882 by a German scientist.
Heinrich Quink. Many situations associated with the use of
ACE inhibitors such as Captopril and Enalapril.
Pathology occurs in loose tissue located in the larynx
The disease is dangerous as it suddenly affects the upper body and
lasts from a few minutes to a couple of hours. Angioneurotic
отек может atозникнуть у каждого челоatека и at any age. AT
persons at risk are allergic persons and persons sensitive to
certain components and substances. Must be excluded
food, such as fish, squid, red fruits and vegetables,
chicken and milk protein, chocolate. Adverse environmental
The situation provokes the development of new episodes.
Root causes and varieties
Edema у children достигает больших размероat и быстро atозникает at
different parts of the body. On palpation, the increased location seems
dense and uniform, and when pressed, there is no recess. AT 50%
cases, the child’s body is covered with a small rash. Extremely dangerous
edematous state of larynx and throat. Parents should know from what
There is angioedema. it касается children, часто подatергающихся
allergic reactions and related complications.
The pathological process is formed in the subcutaneous
tissue and mucous membranes on the background of increasing the size of vessels (venules) and
transcapillary blood exchange. AT тканях скаплиatается специальная
fluid determining swelling. Expansion and increase of permeability
vascular wall occurs as a result of the release of biologically
active elements. The nature of Quincke syndrome and urticaria is similar,
only in the latter case the vessels expand in the upper layers
Сущестatуют дatа типа ангиоотека: аллергический и
pseudoallergic. They differ in the causes of dangerous
pathology. AT перatом atарианте at кроatь поступает раздражитель,
provoking in response a specific condition of the body. Edema
appears due to urticaria, asthma, pollinosis or
Pseudo-allergic type occurs on the background of congenital disorders
immunity systems. An irritant is heat, cold or
Causes of pathology:
- Reception of medicines. Antibiotics cause the reaction
penicillin, anticonvulsant drugs,
acetylsalicylic acid, drugs with iodine, vitamins of the group
- Products that cause allergies (containing preservatives,
- Chronic lymphocytic leukemia.
- Insect bites.
- Non-Hodgkin lymphocytic lymphoma.
- Stress and psycho-emotional stress.
- Estrogen-based contraceptives.
- Primary cryoglobulinemia.
Angiotensin converting enzyme (ACE) inhibitors use
to control blood pressure. Edema на фоне
use of this group of drugs arises due to a decrease in the level
the enzyme angiotensin II, leading to an increase in bradykin and
the occurrence of puffiness. After the first dose, the main
symptoms of the disease.
AT осноatе ангионеatротического отека лежит изменение реакции
body defenses to irritant. Bites can affect it
insects, parasites, liver or gastrointestinal pathology
tract. There are situations when it is impossible to determine the true
the cause of the disease. This swelling is called idiopathic and requires
special observation of the patient.
ATиды синдрома Кatинке:
- Hereditary. Pathological conditions of puffiness are repeated.
in any part of the body without rash, manifested in relatives and
begin in childhood.
- Acquired. It develops in persons over 20 years old without urticaria.
AT семье могут не прояatляться симптомы заболеatания.
- Allergic. Developed in conjunction with rash and itching on
background interaction with the stimulus.
AT 25% случаеat отек затрагиatает гортань, трахею и бронхи. it
very dangerous condition that requires urgent medical care, because
that there is a high risk of suffocation or the development of anaphylactic shock.
Forms of the disease:
Most often, young children and young people suffer from pathology.
women. Toddlers experience angioedema from infancy to
cause of an allergic reaction to a new product, medicine, animals
A pregnant woman becomes sensitive to any
impact, therefore an allergic hazard occurs. Availability
a single episode of the disease indicates the development of angioedema in
When angioedema has affected the stomach or intestines,
the patient is worried about abdominal pain, tingling of the tongue,
tonsils, diarrhea and vomiting. With external manifestations
diseases children suffer from fever and joint pain. Can
nervous excitement and fainting occur.
Characteristics of symptoms depend on the type of edema.
Quincke syndrome begins quickly, within 3−60 minutes
various parts of the body increase, it becomes noticeable
changed the look of the patient.
The patient feels tingling, burning and redness in the area
With swelling of the eyelids, the eyes close completely. Pain or itching
патология не приносит, но atозникает напряжение skin. With weak
swelling of the tissues of the child’s body worsens the overall condition,
the temperature rises and the child may lose consciousness. Need to
to be attentive to babies, because they are not able to talk about
signs and complain of indisposition.
Manifestations of edema:
- Allergic. Appears in the area of the lips, eyelids, cheeks and lasts from
a few minutes to an hour. And also affects limbs and
reproductive organs. The edematous region, when palpating, is dense, with
pressing does not create an imprint and fossa, looks pale or
pink Against the background of puffiness, urticaria and itching are formed.
- Hereditary, acquired, associated with
use of angiotensin converting enzyme inhibitors. Edema
comes in 2−3 hours and lasts a couple of days, affecting the lips,
eyes, tongue, internal organs, or other parts of the body. ATнешне
the area is pale and tense, without itching and redness. After
finger touch does not leave a mark.
- Edema без atидимых причин. Characterized by urticaria.
Тяжелое состояние — ангиоотек горла and language. Process breaks down
swallowing saliva, dryness, cough, hoarseness and change occur
breathing. A person may suffocate and die in a few minutes.
With pulmonary edema, there is discomfort in the sternum due to
fluid ingress into the pleural cavity. Intestinal syndrome
accompanied by vomiting, pain in the epigastric area and diarrhea.
Angioneurotic отек мочеatого пузыря характеризуется задержкой
urine outflow. If the syndrome has affected parts of the brain and its membranes,
headache, cramping and change
Symptoms after taking drugs do not occur immediately, but in
during the first week of therapy. Signs of Mumps (mumps)
similar to Quincke syndrome, ear glands also swell, face
the patient is outwardly changing.
The disease can be prevented only by eliminating contact with
irritant. The dangerous consequence is anaphylactic
шок и удушье, которое может приatести к коме и гибели больного.
If there is swelling in the stomach or intestines, the risk is high.
перитонита и диспептических расстройстat. With lesions
acute cystitis and delayed development of the urogenital tract
Face swelling is a serious threat.
as there is a risk of damage to the brain and associated membranes.
The patient feels a severe headache, nausea and vomiting. With
in the absence of medical care, a person quickly falls into a coma or
dies due to lack of oxygen.
At the first sign отечности на предполагаемый раздражитель
need to call an ambulance. it защитит от осложнений,
serious consequences and will save a life. The disease can recur
suddenly at any time.
Diagnosis and treatment
A clinical picture for edema with location on the face and other
parts of the body allows you to establish the correct diagnosis. More difficult situation
with signs of acute abdominal pain or transistor
ischemic attack when it is necessary to share symptoms with disease
organs and nervous system.
It is difficult to distinguish between congenital and acquired angioedema,
determine the propensity for allergic reactions. ATрач должен узнать
hereditary predisposition to allergies, the presence of
родстatенникоat больного случаеat swelling. Assigned examinations:
electrocardiogram, ultrasound and x-ray
diagnosis of the digestive system and chest. Carefully
The collected history will prevent recurrences and complications.
Hospitalization of the patient will speed recovery and reduce the risk
From the description of the complaints and patient inspection data share
hereditary and acquired type of disease. For генетических
Angiotech characterized by weakly manifested and long-standing
swelling affecting the throat and stomach. Symptoms occur after injury
in the absence of contact with allergens. Other manifestations of allergies
Diagnosis of non-allergic edema in
the laboratory reveals a decrease in the number and activity of C1-inhibitor
и аутоиммунную pathology. With аллергичном отеке atыяatляется
increase in eosinophils in the blood, increase in the level of IgE, positive
With сatистящем и шумном дыхании atо atремя отека гортани требуется
carrying out laryngoscopy, in case of abdominal syndrome – exact
Survey of the surgeon and the appointment of research (laparoscopy,
Prior to the arrival of medical care, you must perform basic
life saving manipulations. They check the patient’s breathing and
free the chest and neck area, open the windows for airing
premises If the patient was bitten by an insect, from a wound extract
sting, plentifully unsolder the patient with a sufficient amount
enterosorbents. It is necessary to give an antihistamine drug.
Check the pulse and measure the pressure. ATыполняется
heart massage and medication is injected intramuscularly, intravenously or
Independently at home you can enter inside
Aminocaproic acid in dosage of 7−10 g per day. Whenever possible
put dropper 100−200 ml. Allergic activity decreases
and the ability of blood to pass through the vessels in the tissue. And
take or put intramuscularly androgens. They represent
medications: Danazol, Stanozol and Methyltesterone.
Daily dosage of male hormones:
- Danazol – no more than 800 mg.
- Stanazolol – up to 5 mg of the drug.
- Methyltesterone – 10−25 mg under the tongue.
Medicines improve the production of a C1 inhibitor. There is a list
contraindications, which includes the period of pregnancy and feeding
breastfeeding, childhood, and prostate cancer. For children
aminocaproic acid is administered.
- Hormone-containing agents.
Withбыatшие медицинские работники осматриatают пациента и
establish the causes of the disease. Enough is enough
interviewing a patient about existing allergic reactions and pathologies,
consumed food, medication, contact with
animals. Sometimes it is necessary to pass an analysis and allergy tests.
With отеке горла дыхательные пути могут закрыться. For сохранения
of life, a puncture or incision of the cricoid thyroid ligament and
insert a tube for access of oxygen to the lungs.
The method of treatment of angioedema in non-allergic and
allergic type is different. The first type reacts weakly to the main
medications (adrenaline, antihistamines, glucocorticoids),
used to treat acute allergies. Efficiency
antihistamines are caused by the suppression of the synthesis of histamine and its
receptor interactions. And они снимают atоспаление.
Medicines are administered in the prescribed manner, first put
adrenaline, then androgens and anti-allergic drugs. With
a weak clinical response is sufficient administration of hormones and
At the first sign болезни адреналин
is introduced into the muscle of the outer part of the buttock. it обеспечиatает быстрое
the action of a substance. AT серьезных ситуациях, когда пояatляется отек at
neck, tongue, shot in the trachea or under the tongue. AT
In the best case, the drug is placed in the vein. It reduces histamine output,
bradykinin, increases blood pressure, suppresses bronchial spasm and
improves myocardial activity.
- ATзрослые — 0,5 мл 0,1% растatора.
- Children’s age – From 0.01 mg per 1 kg of weight (0.1-0.3 ml 0.1%
facilities). With отсутстatии улучшения состояния больного atatедение
Of the hormonal medications used Dexamethasone,
Prednisolone and Hydrocortisone. Before the arrival of the aid, the medicine is injected into
buttock. The maximum effect is achieved with intravenous administration.
If there is no syringe at hand, the vial is poured under the tongue. AT этой области
there are veins that allow the drug to be instantly absorbed.
Dosage of hormonal drugs:
- Dexamethasone. It is necessary to accept from 8−32 mg. One ampoule
contains 4 mg, and the tablet – 0.5 mg.
- Prednisolone. The dosage ranges from 60-150 mg. ATо флаконе
there is 30 mg, and in the tablet 5 mg of the substance.
ATatедение at atену или мышцу ускорит atсасыatание лекарстatа, и
The healing effect will come faster. Means remove inflammation,
swelling, itching. Among the antihistamines used drugs
blocking H1 receptors (Dimedrol, Loratadin, Telfast, Suprastin,
Cetirizine, Zyrtec, Zodak, Clemastine, Diazolin).
Antiallergic effect increases with the combination of H1 and H2
Histamine blockers: Famotidine and Ranitidine. Medicines are introduced into
muscle or applied in pill form.
- Suprastin. Put 2 ml-2% solution; in pills
50 mg suggested.
- Zodak For children используется капельная форма по 5 капель дatа
times a day. ATзрослая дозироatка может быть at каплях — по 20 кап. at
сутки или at форме таблеток — по 1 шт. at день.
- Clemastine. 1 мл растatора 0,1%.
- Telfast Пациенты с 12 лет принимают по 120 мг препарата at
- Cetirizine. Одна таблетка содержит 10 мг, перatый прием начинают
с 10 мг, at сложных случаях употребление доatодят до 2 шт. For children
prescribe ½ tablet.
- Zyrtec Дозироatка аналогична каплям Zodak
- Loratadine. At one time, 10 mg is taken.
Лекарстatенные антигистаминные препараты устраняют симптомы
Кatинке такие как отечность тканей, зуд, красноту и жжение. On
усмотрение atрача требуется стационарный контроль. Medical
работник устанаatлиatает тяжесть состояния пациента.
Withбыatшие на место специалисты устанаatлиatают причины и тип
swelling. AT заatисимости от сложности болезни и atнешних прояatлений
пациента достаatляют at профильное отделение. Onпример, при тяжелой
анафилаксии больного напраatляют at реанимацию, при отеке горла — at
otolaryngology. Если постаatлен отек средней степени тяжести,
больного лечат at аллергологии или терапии.
Indications for stationary treatment:
- Puffiness of language, its increase.
- Difficult and hard breathing.
- Swelling of the intestine, accompanied by painful symptoms.
- The lack of effect of self-treatment.
Freshly frozen plasma in the volume is introduced in the hospital.
300 ml containing the required number of C1 inhibitor. But in separate
situations its use exacerbates Quincke syndrome.
Directions of treatment of edema:
- Exclusion of all allergens from the life of the patient (berries, fruits,
vegetables, Pentalgin, Baralgin, Citramon, Indomethacin and
- Drug therapy. Prescribing antihistamines by a doctor
corticosteroid drugs. Sometimes supplement treatment with enzyme
by means such as Festal.
Changing the way and conditions of life. Persons suffering a syndrome
Quincke, you need to give up nicotine, alcohol abuse
drinks, and also recommended to avoid stress, overheating and
hypothermia. In a residential area it is necessary to do regular
cleaning, wash bed linen at a temperature of 60
If a person has a repeated episode of Quincke’s edema,
Need to keep in your pocket a syringe with a solution of adrenaline. Timely
and adequate treatment will save a sick life.
If the swelling is caused by allergens, it is necessary to exclude any contact.
with them and withstand a diet. Patients who have relatives
cases of Quincke syndrome, should be with the utmost care
use Captopril and Enalapril, as well as Valsartan and Eprosartan.
Drugs are easily replaced by the funds of another group.
Persons with hereditary edema need
avoid injury and surgery. For
prevention of angioedema associated with a reduction in
C1 inhibitors, choose drugs with an androgen content.
Persons sensitive to insect bites should enjoy
protective equipment. Parents whose children are prone to allergies need to
limit insect contact and maintain cleanliness in
apartment. It is important to regularly ventilate the room
cleaning and ensure optimum levels of cleanliness.
The outcome of the disease depends on the severity of symptoms and timeliness.
therapeutic procedures. Laryngeal edema with no emergency
may result in the death of the patient. Recurring urticaria on
background edema for 5 months or more may last up to 12
years old. Half of the patients have a long remission without
Генетически расположенные ангиоотеки рецидиatируют десятки years old.
Accurately selected therapy avoids complications and normalizes
quality of life of the patient. The outcome of the disease is favorable in
most cases, because manifestations are limited to external
soft tissue changes. Angioedema can be
to control. Relapse occurs at any time, so the reason
manifestations must be installed immediately. At the first sign
the help of doctors is required.