Treatment for angioedema. Quincke's edema - emergency measures, further treatment and prevention

Date: 29.06.2020

The disease Quincke's edema (angioedema) is the most severe manifestation of an allergic reaction in the human body. The disease occurs suddenly and also develops rapidly. It is a local edema (limited or diffuse) of the subcutaneous tissue and mucous membranes. Sometimes this disease is called angioedema or giant urticaria.

One of the varieties of Quincke's edema

Pathology occurs in about 2% of people at a young age, mainly in women and children. It occurs like a common allergy, but it is very dangerous and the patient can go to intensive care. In addition, serious complications may occur, including death.

This condition was first published by the scientist Heinrich Ireneus Quincke, after whom the disease was named. Back in 1882, he discovered it and described the symptoms in detail. Many patients may have a combination of edema and acute urticaria. In this material, we will try to explain in detail and tell you what Quincke's edema is and what effective methods of treatment are available. In addition, we will consider photos, symptoms and causes of the disease, as well as general recommendations and preventive measures.

Quincke's edema (angioedema) is an acutely developing local edema of the skin, mucous membranes, subcutaneous tissue. The disease can be of a pseudo-allergic or allergic nature. The disease can often be observed on the face (swelling of the lips, eyes, eyelids, tongue, cheeks), on the neck, on the legs, and even in the nose. In some cases, a dangerous pathology appears in the groin, in the respiratory tract, in the gastrointestinal tract and in the genitourinary organs.

If Quincke's edema develops in the tongue and throat (larynx), in this case there is a possibility of airway obstruction with the subsequent threat of asphyxia. In such cases, the patient needs urgent resuscitation, since there is a risk of human death. The hereditary form of angioedema is diagnosed in about 25% of patients, the acquired form in 30% of patients, and in other cases it is not possible to identify the cause of the disease. In half of cases, edema occurs in combination with urticaria.

The onset of severe swelling in the tongue

The pathogenesis of the development of edema is associated with an increase in the permeability of the walls of blood vessels and an uneven distribution of fluid through the tissues of the body. The spread of an allergic reaction begins with the antigen-antibody stage. Allergy mediators begin to affect the nerve trunks and blood vessels, seriously impairing their working function. As a result, the vessels begin to expand, increasing their permeability. As a result, plasma enters the intercellular space and local edema develops. Nerve cells do not work actively, leading to paralysis of the nerve trunks. Vessels cannot come to their usual tone, and this leads to even greater relaxation of their walls.

Quincke's edema can occur acutely and quickly, and the duration of the reaction can be 2-3 days. It all depends on the amount of the allergen and the duration of its exposure. Following the clinical manifestations, if it is acute edema, then the duration of the course is less than 1.5 months. The chronic course of the disease can last from 1.5 to 3 months or even longer. Doctors distinguish angioedemas, both isolated and combined with urticaria. Knowing the causes of allergies, treatment of Quincke's edema can pass without serious consequences.

Photo of Quincke's edema on the face

Photos of Quincke's edema on the hands

Symptoms of Quincke's edema

The main symptoms of edema

In many cases, the main symptoms of Quincke's edema are an increase in size and swelling of the soft tissues of the face, neck and head. The patient's face may swell so much that the head will look like a balloon, and instead of eyes there will be only slits and it is impossible even to lift the eyelids. In addition, the disease can manifest itself on the hands, especially on the toes, on the feet in the area of the foot, and on the upper chest.

With Quincke's edema, the allergy manifests itself sharply and develops very quickly within a few minutes (less often - several hours). Giant can develop on parts of the body and organs with a developed layer of subcutaneous fat.

The main signs of the development of Quincke's edema:

Quincke's edema in a child is a fairly common phenomenon. In addition, at such a young age, the pathological process, as a rule, has its own characteristics, especially in newborns and infants. Edema in children in most cases reaches a larger size than in adults. The disease that has arisen can be of a migratory nature, occurring in one or another place. If you feel the place of swelling, then it will seem quite homogeneous and dense. If you press, the grooves do not appear. In about half of the cases of angioedema in children, urticaria will occur.

Swelling of the larynx and throat is especially dangerous in a child. The processes of pathology in a child, as a rule, develop very quickly in comparison with adults. That is why if there is even the slightest suspicion, urgently call an ambulance.

Quincke's edema in a child

If the reaction has affected the parts of the gastrointestinal tract, then the child will be disturbed by sharp and severe abdominal pains, tingling of the palate and tongue. Diarrhea or vomiting may begin, which will appear a little later.

If the swelling develops only on the skin, children may suffer from severe joint pain and fever. The child may be agitated and may faint.

If parents know that the child is prone to allergies, they must know the causes of the disease and what exactly can cause life-threatening Quincke's edema:

- It may be some medications. Various antibiotics, seizure relievers, acetylsalicylic acid, B vitamins, preparations that contain iodine;

- Some foodstuffs that can provoke an allergic reaction and all kinds of food additives;

- Bites of various insects. Wasps, mosquitoes, hornets, gadfly, bees;

- Pollen, which is released during the flowering period of some plants.

Symptoms of Quincke's edema in children

Signs of Quincke's edema in young children are often not so easy to recognize and parents should be prepared for this. The syndrome in a child is more dangerous than in adults, and the baby will not be able to tell what happened to him and what his feelings are.

If a child develops pallor on the skin, a bluish tinge in the nasolabial region, rapid heartbeat and shortness of breath, then the body feels a lack of oxygen associated with laryngeal edema. Cyanosis in the future can go to other areas of the skin, there is increased sweating. After this, suffocation may occur with a decrease in pulse rate and loss of consciousness.

The rate of development of the disease, both in adults and in children, in individual cases may differ. The edema can completely disappear in a few minutes, and sometimes it can progress for a long time over several days. Everything will depend on the amount of allergen that has entered the body and on the duration of its action. The duration of the edema can also vary. If several weeks do not pass, the edema flows into a chronic form.

Causes (etiology) of Quincke's edema

Why does Quincke's edema occur? In order to prevent a dangerous allergic condition, you should always know what exactly causes the appearance of edema. Here it is impossible to say unequivocally, since these are individual circumstances for each person. Absolutely any substance can act as an allergen, which can be dangerous for one person, and for others does not pose any threat. There are fast and especially severe allergic reactions that develop in response: this is the poison of insects and snakes.

Attention!
In about 30% of cases of Quincke's edema, it is diagnosed as idiopathic, when there is no way to determine the root cause of the disease.

Knowing the reason, the doctor in the clinic will be able to prescribe the most effective treatment for Quincke's edema. However, a situation may arise when the patient needs urgent help. In this case, you need to act quickly and, most importantly, do not panic.

First aid for angioedema

The disease Quincke's edema can develop very unpredictably and pose a great danger to the patient's life. First of all, what needs to be done is to call an ambulance team, even if the general condition of the patient is stable and satisfactory. Do not panic, do all the action clearly and quickly.

Before the arrival of the first aid team

1. The patient should be seated in the most comfortable position and calm down. You yourself should also calm down.

2. Limit direct contact with the allergen. If it is a bite of a wasp, bee or other insect, then you need to remove the dal from the skin. If it is not possible to do this on your own, wait for the arrival of the doctors.

3. Emergency treatment includes taking antihistamines. Give fencarol, diphenhydramine, or diazolin. The most effective are injectable forms of antihistamines, since there is a likelihood of developing edema of the gastrointestinal tract, and there was a violation of the absorption of substances. In any case, take 1-2 tablets of the drug if it is not possible to give an injection. Observe the dosage level when injecting. Thanks to drugs, you can relieve the patient's condition and weaken the reaction before the ambulance arrives.

4. First aid includes an obligatory plentiful drink: for 1000 ml of water you need 1 gram of soda, or mineral water such as Borjomi or Narzan. Thanks to the use of fluids, the allergen can be removed from the body.

5. Use sorbents. You can use ordinary activated carbon or enterosgel.

6. Apply a cold compress, ice, or a heating pad with cold water to the affected area to relieve itching and swelling.

7. Be sure to need fresh air, remove objects that may obstruct breathing.

8. Release of the victim from tight clothing, belt, belt, tie;

If this is a very severe degree of edema, then in this case, do not take any measures on your own so as not to worsen the patient's condition and wait for the medical team. The main rule is do not harm.

A medical team can provide first aid in a timely manner

After the emergency ambulance arrived

The provision of first aid should be aimed at the implementation of such tasks as:

1. Stop exposure of the patient's body to a possible allergen. This is necessary so that the disease does not progress. With the first aid, a cold compress gives an excellent effect. You can use a heating pad with water or ice. If Quincke's edema is due to an insect bite, then injections will help, as well as a tourniquet applied slightly above the bite / injection for about 30 minutes.

2. Conduct hormonal therapy. In order to eliminate edema and normalize breathing, treatment with glucocorticosteroids is used. With giant urticaria, you can use the drug "Prednisolone". If a combination of edema with urticaria is diagnosed, then Dexamethasone can be used in the treatment.

3. Use desensitizing therapy. Antihistamines will help reduce the sensitivity of the body if there is a repeated exposure to the allergen. Such drugs as: "Diphenhydramine", "Pipolfen", "Tavegil" or "Suprastin" are administered intramuscularly.

Naturally, the patient will need urgent hospitalization in the department of allergology. The situation is not excluded when, after an attack, the patient must be in intensive care. In severe cases, urgent help and treatment from qualified doctors is required. The count can go on for minutes.

Video about the disease:

Classification of Quincke's edema

In modern medicine, Quincke's syndrome, taking into account the accompanying factors, is classified into several types:

– acute edema... This disease with severe symptoms persists for up to 45 days;

– chronic edema... The signs of swelling will keep up to about 6 weeks. In addition, relapses may occur intermittently;

– acquired... Over the entire observation period, only 50 such cases were recorded in people over 50 years old;

– hereditary angioedema... According to statistics, 1 case is recorded per 150 thousand cases;

– angioedema accompanied with symptoms of urticaria;

– isolated... Accompanied without any additional conditions;

– idiopathic edema... When the cause of the disease cannot be recognized.

As a rule, doctors focus more on two types of diseases that are similar in appearance:

– angioedema;

– Hereditary(non-allergic) edema.

Absolutely different factors can cause the same symptoms in the disease. In these cases, an inexperienced doctor may not make a completely correct diagnosis. And this is fraught with rather serious complications and the use of the wrong treatment regimen and further therapy, both in the hospital and on an outpatient basis. It is important at the stages of medical care to correctly determine the type of pathology that frolicked in the patient.

What complications can there be with Quincke's edema?

If you do not help a person in a timely manner, then Quincke's edema can develop further and lead to serious complications. Consider the main consequences that may arise as a result of this pathology:

The most dangerous thing that can happen is laryngeal edema. Gradually, the patient will begin to show signs of respiratory failure. There will be symptoms such as: hoarseness, barking cough, shortness of breath;
If swelling of the mucous membrane of the gastrointestinal tract occurs, then an acute abdominal pathology will occur. There will be quite a strong pain in the abdomen, peristalsis will increase, dyspeptic disorder will appear, in some cases a symptom of peritonitis will appear;
With edema of the urogenital system, signs of acute cystitis may occur, and this will provoke urinary retention;
With this syndrome, there can be dangerous complications on the face. The meninges may be involved in the process of edema, provoking the onset of symptoms of meningeal diseases. Signs of Meniere's syndrome will appear. If first aid is not provided, then this is hello to death;
Acute urticaria can be combined with Quincke's reaction.

Diagnosis of the disease

To diagnose the disease, it is necessary to determine the etiological factor that contributes to the provocation of symptomatic symptoms. For these purposes, it is necessary to conduct a very thorough survey of the patient and allergic tests: allergy tests

After the crisis has been overcome and the threat to the patient's life has been completely eliminated, doctors can prescribe laboratory tests such as:

1. Determination of any violations in the complement system, analysis of function for the diagnosis and control of autoimmune diseases.

2. Conducting tests for the detection of specific IgE. The norm is in the range of 1.31-165.3 IU / ml.

3. Measurement of the amount of total immunoglobulin (IgE), which reacts with the allergen and provokes the development of immediate allergic symptoms. It is necessary to conduct an IHLA (immunochemiluminescent) study, in the results the IgE indicator should normally be in the range of 1.31-165.3 IU / ml.

After the patient has recovered, when several months have passed and the antibodies that caused the allergic reaction are still present in the body, the following studies should be carried out:

1. Allergic skin tests. A classic method is used when a possible allergen is applied to the skin. If there is susceptibility, then the skin will develop mild inflammation around the applied agent.

2. An immunogram is analyzed or the patient's immune system is examined.

3. Search for any systemic diseases that can trigger the development of Quincke's edema.

4. If a pseudo-allergic reaction has occurred, then an examination of the whole organism should be carried out and an extensive set of tests (bacteriological, biochemical) should be prescribed, an ultrasound scan, as well as an X-ray of the organs should be done.

After the danger to the patient's life has been eliminated, the specialist can prescribe treatment after Quincke's edema and some preventive measures that will contribute to the patient's full recovery.

Treatment of angioedema

If the patient develops swelling of the throat, trachea or larynx, then emergency hospitalization and referral to hospital treatment are necessary. This group also includes the following categories of patients:

Children;
Patients who have edema for the first time;
Patients with medicinal edema;
People with a severe form of the disease;
Recently vaccinated;
Patients who have suffered a heart attack, stroke, ARVI;
Patients with pathologies of the respiratory system and cardiovascular system.

Inpatient treatment

If a patient has swelling of the larynx, trachea or throat, he is immediately referred to hospital for treatment. Treatment measures are carried out in two stages:

- elimination of an allergic reaction;

- elimination of symptoms, determination of causes, treatment prescription.

Emergency care during the acute period in the hospital is aimed at eliminating (stopping) dangerous symptoms, ensuring the normal functioning of vital functions if a state of shock is observed. Doctors need to reduce the body's response to the allergen.

When treating Quincke's edema in a hospital, the patient can be placed in the allergology department, in the intensive care unit or in the intensive care unit (if there is a severe case). Therapy consists of the use of infusions of antihistamines, diuretics, and glucocorticosteroids. In addition, it is necessary to carry out procedures to cleanse the patient's blood from allergens using sorbents. Elimination of food allergens is carried out using enterosorbents.

In addition to the first generation antihistamines, it is possible to use other drugs from this class, which have a more complex effect on the immune system and minor side effects. This includes "Ketotifen", which is effective not only for edema, but also for bronchial asthma. The drug "Loratalin" can be used during pregnancy and for children over one year old. For the treatment of Quincke's edema in infants, you can use "Fenistide".

If there are clear signs of laryngeal edema, then the dose of drugs can be increased: Prednisolone up to 120 mg, Dexamethasone up to 16 mg. In addition to administering the required medications, emergency and hospital workers may use oxygen inhalation. If a severe case is observed, then incubation of the trachea.

Anti-shock therapy

If the patient has anaphylactic shock, then it is necessary to urgently enter epinephrine. If necessary, the dose of medication can be re-administered. Remember, the break between injections should be at least 20-25 minutes. If there is an unstable dynamics and a high probability of death, the doctor can inject epinephrine intravenously. Simultaneously with the introduction of the drug, blood pressure, respiration and heart rate are monitored. In an adult, blood pressure should not be lower than 100 mm Hg. Art. For a child, this indicator should be at least 50 mm. rt. Art.

In case of anaphylactic shock at the time of the provision of an emergency ambulance, several rules must be observed:

1. The patient should be in a supine position.

2. The head must be turned to the side and it must lie below the level of the legs.

3. The lower jaw must be extended, removable dentures removed from the oral cavity.

If it is not possible to ensure the permeability of air through the mouth, a tracheostomy is applied.

Tracheotomy is performed in the form of cutting the skin and cartilaginous rings of the trachea along the midline of the neck, any strong air-conducting object, for example, the rim of a pen, is inserted into the hole formed.

Standards and general treatment regimen for Quincke's edema

As a rule, the general treatment of Quincke's edema should go in several directions:

- It is necessary to completely eliminate from the life of the victim all allergens that have a potential danger. It is possible to give specific recommendations and direct to the correct treatment only after determining the exact cause of the edema. The patient should refuse to eat foods containing a large amount of salicylates. This includes: raspberries, cherries, peaches, strawberries, strawberries, grapes, apples, plums, apricots, potatoes, tomatoes, carrots. It is also necessary to refuse such medications as: indomethacin, baralgin, paracetamol, citramon and others.

- Drug therapy. This direction of treatment for Quincke's syndrome should be the appointment of a doctor with corticosteroid and antihistamines. If there is a high sensitivity to any individual food products, then enzyme preparations, for example, "Festal", can be used to reduce the reaction.

- The patient will definitely need to adjust his lifestyle. Patients who have undergone edema need to quit smoking, alcohol abuse. In addition, if possible, avoid stressful situations, hypothermia and overheating. To protect a person who has suffered from Quincke's edema, he must always have a syringe with an adrenaline solution with him in case of a repeated severe form of the disease.

Medication for Quincke's edema

What medications should be used to effectively treat the disease? The first generation of drugs include: chloropyramine (suprastin), promethazine (pipolfen, diprazine), fencarol (hifenadine), pheniramine (avil), dimetindene (fenistil), tavegil (clemastine), mebhydrolin (omeryl, diazolin). Some tablets work quite quickly, in about 15-20 minutes. They are very effective in eliminating edema but can cause drowsiness by lengthening the reaction time (contraindicated in drivers). They act on H-1 histamine receptors.

The second generation includes drugs that can block histamine receptors and stabilize mast cells, from which histamine enters the bloodstream. Ketotifen (zaditen) can act effectively by relieving airway spasms. It is used in combination with angioedema with bronchial asthma and other diseases of the bronchi.

Third-generation antihistamines stabilize the mast cell wall, block histamine receptors and do not depress the central nervous system. These include: Loratadin (Clarisens, Claritin), Astemizole (Astelong, Hasmanal, Isalong), Semprex (Acrivastin), Terfenaddin (Teridin, Trexil), Allergodil (Acelastine), Zyrtec, Tsetrin (Cetirizine), Telnadofin) (Fex

If you need urgent help to the patient, then in this case, use drugs: Prednisolone, Dexamethasone, Prednisolone. If the cause of the disease is not determined, the patient needs to undergo therapy with antihistamines that have a long-lasting effect, these are Kestin and Rupafin. This category of drugs is not the main method of treatment, and they can only temporarily eliminate the symptoms of the disease that have arisen.

Prednisolone for angioedema

The drug Prednisolone is a systemic glucocorticoid and is used to provide first aid for angioedema. The medicine can have antihistamine, anti-inflammatory and anti-edema effects. Prednisolone counteracts allergies through several effects:

Reduces the production of antibodies, inhibits growth and differentiates cells;
Prevents mast cell degranulation;
Effectively inhibits the secretion and synthesis of mediators of an allergic reaction;
It well reduces vascular permeability and due to this, edema is removed, pressure rises, and the patency of the bronchi is significantly improved.

The drug Prednisolone

With edema, Prednisolone should be administered intravenously at a dosage of 60-150 mg. For a child, the dose should be calculated based on body weight: 2 mg per 1 kg of body weight.

The use of this medication may cause side effects. These are ulcerative bleeding, arterial hypertension, and arrhythmia. This will be a contraindication to the use of this drug. Remember that the required course of treatment should be prescribed by a specialist doctor and you should not decide for yourself what to take. This also applies to folk remedies.

2. Tea made from birch leaves. 15 grams of dried and crushed birch leaves are poured with a glass of boiling water, the resulting mixture is infused for 20 minutes and drunk. This tea is used two or three times a day. The plant has a pronounced diuretic effect and is able to relieve swelling in the tissues. Birch leaves are also advised to use for arterial hypertension, for acute or chronic pathologies in the urinary system.

Remember!
Treatment of the disease with medicinal herbs and plants must necessarily be carried out under the supervision of the attending physician in order to prevent the development of complications.

Home treatment using traditional medicine is carried out in order to strengthen the general condition of the body.

To prepare herbal tea, you can use plants such as:

Treatment and diet for angioedema

Diet therapy is one of the components in the treatment of almost any disease. When developing a competent diet, it is very important to take into account the pathogenetic mechanisms of the disease, as well as the state of various organs and organ systems. If treatment of angioedema is required, it is important to develop the correct diet.

Diet with angioedema should take into account several principles:

- It is necessary to exclude from the diet foods that can cause both direct and cross-reaction. The dietary menu should not contain foods that have a high amine content. Whenever possible, products should be natural and not contain synthetic additives;

- If any products are excluded, then they must be correctly replaced. Thanks to this, you can adjust the quantitative and qualitative composition of the menu;

- There must be "functionality". All consumed dietary products should only benefit and help strengthen the patient's body.
Observing the rules and advice on nutritional therapy, there will be positive dynamics in the treatment. Of course, the diet will be effective if any food product is the allergen. Thanks to the patient's examination data and knowing information about food intolerances, it is possible to exclude allergenic foods from the diet. You can simplify the task with the help of a food diary, which must be kept constantly.

However, the body must receive the full range of essential substances, so fasting should not be too long. You need to introduce products smoothly, as a rule, from some one type, for example:

1. The patient begins to consume semi-liquid mashed potatoes without adding oil. A serving is 100 g on an empty stomach, then 200 g 4 times a day.

2. When the body adapts to the need for full digestion of food, other products are added to the potatoes in the same way. It is important that there are no additives in the dishes (exclude butter, milk, fruits, vegetables).

3. Before the introduction of each product, "provocation" is first carried out: on an empty stomach, you need to eat 100 g of this dish.

There is a conditional order according to which hypoallergenic products should be introduced. The plan for the inclusion of additional meals depends on the patient's nutritional characteristics (identified hazardous products). The following sequence is considered the most rational:

Potato;
carrot;
dairy products;
bread (preferably stale);
cereals;
beef;
a fish;
poultry meat;
eggs.

Quite often, the appearance of allergies and edema is caused by various synthetic food additives. Among them are preservatives (sulfites, nitrites, benzoic acid and its derivatives, etc.) and dyes (tartrazine, amaranth, azorubin, erythrosine, etc.), flavorings (menthol, vanilla, cloves and cinnamon, glutamates) and all kinds of taste stabilizers.

The outcome in Quincke's pathology in most cases will depend on the level of manifestation of edema and the speed of first aid. It is necessary to properly support the selected treatment, which can significantly reduce the risk of recurring allergies. Preventive measures to prevent Quincke's edema depend on the type of pathology.

If this is an allergic genesis, then in this case it is necessary to properly observe the correct dietary nutrition and exclude potentially dangerous medicines and medications. If the allergy is hereditary, then it is necessary, if possible, to avoid viral infections, taking ACE inhibitors, injuries, stressful situations.

You always need to be ready and have the necessary medications with you to help cope with the manifestations of allergies, as well as be able to timely recognize Quincke's edema, the symptoms inherent in it. You need to know how first aid is provided for Quincke's edema. Unfortunately, it is not always possible to count on quick medical help or go to the clinic, and the patient's life may depend on the speed of providing first aid to the patient.

Quincke's edema is an acute condition in which there is significant swelling of the skin layers and subcutaneous fat, sometimes with involvement of the mucous membranes in the pathological process. The disease is named after the doctor G. Quincke, who first described it in 1882. The second name of the pathology is angioedema.

Quincke's edema - causes of occurrence

Like urticaria, Quincke's edema is associated with vasodilation and an increase in their permeability to the liquid blood medium, however, in this case, puffiness appears not in the superficial, but in the deep skin layers, mucous tissues, and the subcutaneous fat layer. The accumulation of penetrating interstitial fluid in the tissues determines the edema. The expansion of blood vessels and an increase in their permeability occurs due to the release of biologically active substances (bradykinin, histamine, etc.), which occurs as a result of the immune response under the influence of certain factors.

One of the rare varieties of the pathology under consideration - hereditary angioedema - is associated with a violation in the complement system, inherited. The complement system, which is composed of the pooling of protein structures, is an important component of the immune system that is involved in inflammatory and allergic reactions. This system is regulated by a number of enzymes, including the C1 inhibitor. With a deficiency of this enzyme, uncontrolled activation of complement and a massive release of substances that cause edema occur.

The first signs with hereditary Quincke's edema can appear even in childhood, but in most cases they debut in puberty or middle age. The development of an attack is often preceded by certain provoking phenomena:

infections;
powerful emotional stress;
surgery;
trauma;
taking any medications.

Allergic Quincke's edema

Allergies are the most common cause of Quincke's edema. At the same time, the ailment is often combined with other diseases of an allergic nature - hay fever, bronchial asthma, urticaria, etc. If the mechanism of occurrence of the pathology in question is allergy, Quincke's edema acts as a kind of response to the stimulus. Irritating factors can include:

food products and additives to them (fish, citrus fruits, honey, nuts, chocolate, flavorings, dyes, preservatives, etc.);
feathers and down of birds;
insect poison and saliva;
room dust;
household chemicals;
solar radiation;
high or low temperatures;
medicines, etc.

Idiopathic Quincke's edema

There is also an idiopathic angioedema, the cause of which is not clear. In this case, attacks of an inadequate reaction of the body cannot be associated with any specific antecedent factors. Many experts call this form of pathology the most dangerous, because, not knowing what provokes edema, it is impossible to prevent its appearance and eliminate the action of the culprit factor.

Quincke's edema - symptoms

Angioedema symptoms are pronounced, which are difficult not to pay attention to, including because they can cause considerable discomfort and hinder the functioning of some parts of the body. Edema in the affected area is noticeable with the naked eye, the skin (or mucous membrane) looks swollen, while practically not changing its shade (only later it can turn noticeably pale).

Common sites of localization are:

face;
oral cavity;
language;
larynx;
trachea;
genitals;
upper and lower limbs;
internal organs (stomach, intestines, bladder, meninges, etc.).

In the affected area, patients feel tension, tightness, slight soreness, burning sensation, tingling, rarely itching. Affected internal organs can cause reactions such as severe abdominal pain, nausea, vomiting, diarrhea, cramps when urinating, headache, etc. Affected airways react with shortness of breath, coughing, difficulty breathing, and can provoke choking. Quincke's allergic edema is often accompanied by the appearance of itchy red rashes. A slight burning sensation and itching may be the harbingers of puffiness.

How quickly does Quincke's edema develop?

In most cases, if an allergic reaction is involved in the development mechanism, Quincke's edema appears rapidly, starting suddenly. Symptoms develop within 5-30 minutes, and resolution should be expected after a few hours or 2-3 days. With a non-allergic nature of the pathology, puffiness often develops within 2-3 hours and disappears after 2-3 days.

Angioedema of the larynx

Angioedema of the throat is a serious danger to the body and can even cause sudden death. In just a few minutes, the airways can be completely blocked due to swollen tissues. Dangerous signs that should be an urgent reason to call an ambulance are:

blue skin of the face;
strong wheezing;
a sharp drop in blood pressure;
convulsions.

Angioedema of the face

On the face, Quincke's edema, a photo of which shows pronounced symptoms, is often localized in the eyelids, cheeks, nose, and lips. In this case, the eye slits can sharply narrow, the nasolabial folds can be smoothed, one or both lips can sharply increase in size. Edema can rapidly spread to the neck, affect the airways and block air. Therefore, Quincke's edema on the face should be stopped as early as possible.

Angioedema of the extremities

Signs of Quincke's edema, localized on the arms and legs, are often observed on the back of the feet and palms. This type of reaction is less common than those described above and does not pose a particular threat to the functioning of the body, although it does cause significant discomfort. In addition to the appearance of limited areas of induration on the limbs, the skin can acquire a bluish tinge.

What to do with angioedema?

Patients who have had an episode of sudden swelling of a particular part of the body at least once in their life should know how to relieve Quincke's edema, because the pathology can arise again suddenly. First of all, an ambulance team should be called, especially when swelling appears in the respiratory tract or there is a suspicion of localization of pathology in the internal organs. Before the arrival of health workers, first aid measures should be taken.

Quincke's edema - first aid

Emergency care for Quincke's edema, which can be provided before the ambulance arrives, includes the following steps:

Isolation of the victim from the action of the stimulus (if installed).
Providing free access to clean air.
Release of the patient from squeezing clothing and accessories.
Positioning the patient in a semi-seated or seated position to facilitate breathing.
Maintaining a calm environment around, preventing panic.
Applying a cold compress to the affected area.
Providing plenty of fluids (preferably alkaline).
Taking medications: vasoconstrictor nasal drops (Naphtizin, Otrivin), antihistamines (Fenistil, Suprastin) and sorbents (Enterosgel, Atoxil) inside.

The above measures, which provide for assistance with Quincke's edema, are necessary, first of all, when there is:

swelling of the nose;
swelling of the lips;
swelling of the oral mucosa;
swelling of the throat, larynx;
swelling of the neck;
swelling of internal organs.

How to treat angioedema?

Emergency drug therapy to eliminate acute edema and restore vital functions may include the use of such drugs:

Adrenaline - with a decrease in blood pressure;
Prednisolone, - with Quincke's edema, the main manifestations are removed;
Glucose, Gemodez, Reopolyglyukin - to eliminate shock and remove toxins;
Diphenhydramine, Suprastin injection - with an allergic reaction;
Furosemide, Mannitol - at normal and elevated pressure to remove excess fluid and allergens;
Euphyllin with Dexamethasone - to relieve bronchial spasm, etc.

Non-allergic Quincke's edema has a different treatment, sometimes carried out by blood plasma transfusion and the use of such drugs:

Z-aminocaproic acid;
Contrikal.

Outside the acute stage, treatment may include:

elimination of established stimuli;
short courses of hormone therapy (Prednisolone, Dexazon);
the use of drugs to strengthen the nervous system and reduce vascular permeability (Ascorutin, calcium, vitamin complexes);
taking antihistamines (Loratadin, Suprastin, Cetirizine).

This term is usually understood as a very serious disease, which most often has an allergic nature and is accompanied by unpleasant symptoms.

Quincke's edema, whose complications pose a threat to life, requires urgent medical attention.

Harbingers

Before the onset of an attack, a person feels a slight tingling and burning sensation in the area of edema.

About 35% of people notice that their skin or limbs turn red before or during the onset of edema.

However, most people develop an attack extremely quickly without any precursors.

Within a short period of time, the patient's neck and lower face area swell.

The main symptoms

As already indicated, pathology has a sudden onset. Within a few minutes or, in more rare cases, hours, severe edema appears on the mucous membranes and various areas of the face.

A person may experience local edema, which:

affect the lips;
eyelids;
scrotum.

Also, the oral mucosa can be exposed to these symptoms - in particular:

language;
sky;
tonsils.

Often they swell:

respiratory tract;
digestive tract;
genitourinary organs.

Edema rarely provokes pain. In most cases, patients experience a feeling of tissue tension.

When pressure is applied to the skin, the fossa does not remain, and the feeling of swelling does not cause discomfort.

Quincke's edema usually affects the lower lip, tongue, cheeks, eyelids, and larynx.

Localization of pathological changes in the tongue and larynx is considered the most dangerous, because it provokes the development of asphyxia.

In this case, the person is faced with a breathing disorder. He develops a bluish tongue and aphonia.

If the pathology affects the brain and its membranes, there is a risk of neurological symptoms.

The patient may experience:

epileptiform seizures;
hemiplegia;
aphasia and other disorders.

Quincke's edema persists for several hours or days, after which it disappears without a trace. However, in some cases, relapses of the disease are observed.

Complications of Quincke's edema

The disease may disappear on its own after a few days. However, sometimes it provokes the appearance of negative health effects.

In about a quarter of cases, the reaction that appears in the area of the lips and mucous membranes of the mouth extends to:

organs of the respiratory system;
affecting the pharynx;
trachea;
larynx.

As a result of this process, asphyxia develops.

When the mucous membranes of the respiratory tract are affected, the following symptoms appear:

hoarseness in voice;
breathing disorder;
increased anxiety;
feeling of panic;
barking cough;
blueness of the face;
fainting.

If such complications of Quincke's edema occur in adults, you must immediately call an ambulance. With rapidly developing asphyxia, there is a risk of death.

In more rare cases, the disease provokes the following complications:

swelling of the mucous membrane of the digestive system- in this case, symptoms of dyspepsia and acute abdominal pain appear.
swelling of the mucous membranes of the genitourinary system- in such a situation there is a risk of developing acute cystitis and urinary disorders.
swelling of the lining of the brain- such a violation is rare, but it can lead to death if the patient is not helped in a timely manner. The main manifestations of cerebral edema include nausea, vomiting, headaches, general weakness, and inhibition of reactions.

Another characteristic symptom of this condition is the stiffness of the muscles of the back of the head. In this case, the person cannot tilt his head forward and reach the chest with his chin.

Video: Major Dangers

Consequences in children

This symptom can provoke dangerous consequences in children. With a recurrent course of the disease, there is a threat of the development of edema of the larynx and internal organs.

There is also a risk of bronchospasm and anaphylactic shock.

In a quarter of cases, when the larynx, bronchi, trachea are involved in the pathological process, the child's life is in danger, since he may die from suffocation.

In addition, in difficult situations, Quincke's edema is the beginning of anaphylactic shock, which also poses a threat to life.

Therefore, the very first symptoms of a violation should be a reason for urgent measures. Only timely medical assistance will provide the child with a quick recovery without negative health consequences.

Dangers

The most difficult and dangerous consequences of the disease include edema of the larynx, trachea and large bronchi.

As a result, the patient develops an acute lack of oxygen, which requires urgent medical attention.

Sometimes the symptom becomes the beginning of the development of anaphylactic shock, which is a serious danger to life.

In this case, a person develops skin rashes, swelling in the neck area, dizziness, nausea, and respiratory failure. In addition, a sharp drop in pressure provokes an impairment of consciousness.

Diagnostics

After eliminating the acute symptoms of the disease, it is necessary to determine the causes of the development of pathology.

To make an accurate diagnosis, the doctor must identify the following data:

the presence of allergic diseases;
reactions to medications;
the seasonality of the onset of symptoms;
having a reaction to serum or vaccines;
the connection of symptoms with infectious pathologies;
food exposure;
the influence of physical factors;
living conditions.

During an exacerbation, a specialist may prescribe laboratory diagnostic methods:

Evaluation of the level of immunoglobulin E in the blood serum.
Quantification of specific immunoglobulins E in the blood to allergens. For this, ELISA and multiple allegosorbent testing are performed.
Analysis of the complement system.

The rest of the tests are carried out 2-3 months after recovery - it is during this period that the required amount of antibodies to allergenic substances is heated in the patient's blood:

Skin tests with allergens. To do this, a small amount of a potentially hazardous substance is applied to the skin area. This is done by injecting it intradermally, making small abrasions, or applying it to the skin. In the presence of sensitivity to an allergen, inflammation appears within half an hour.
Study of the immunogram. With the help of this procedure, it is possible to assess the state of the human immune system.

If the edema is of non-allergic origin, a detailed examination is required. It includes performing a general clinical analysis. Bacteriological and biochemical studies may also be required.

Providing emergency care

To save a person's life, he needs to provide first aid in a timely manner:

When blood pressure drops, an adrenaline solution with a concentration of 0.1% is injected under the skin. Typically 0.1 to 0.5 ml is required.
With the development of suffocation, it is necessary to perform adrenaline injections.
Be sure to inject hormonal drugs- in particular, the use of glucocorticosteroids is shown. The patient requires intramuscular or intravenous administration of 60-90 mg of prednisolode. Also, intravenous administration of 8-12 mg of dexazone is carried out.
Desensitizing treatment prescribed- antihistamines are used for this. The doctor can inject suprastin intramuscularly. Erius, zyrtek are also often used.
The use of diuretics is of no small importance. In this case, 40-80 mg of lasix is used, which is mixed with 10-20 ml of saline.
Protease inhibitors are used. The doctor can use 30,000 IU of contrikal or 200 ml of epsilon-aminocaproic acid.
Detoxification therapy is in progress- it consists in performing hemosorption and enterosorption.

How to treat to prevent the consequences

In order to prevent the development of dangerous complications, it is necessary to carry out complex treatment, which includes the following components:

Exclusion of contact with allergenic substances.
The use of funds to improve the tone of the sympathetic nervous system. For this purpose, ephedrine, calcium, vitamin C are prescribed.
Decrease in parasympathetic activity. In this case, atropine is used.
Vitamin therapy. To reduce vascular permeability, askorutin is used.
Desensitizing treatment. For this, cortisone, prednisone is prescribed. They also conduct a course of therapy with gamma globulin and B vitamins.

If Quincke's edema is of hereditary origin, drugs are prescribed to enhance the production of the missing C1 inhibitor.

In order to prevent dangerous complications, it is worth following the following recommendations of doctors:

Identify the allergen and eliminate contact with it. If a reaction occurs to an insect bite, it is worth removing the sting, and treating the bite with alcohol.
Provide the patient with access to fresh air.
Give a person a lot to drink.
Give a sorbent - for example, enterosgel or activated carbon.
Give the victim an antihistamine - claritin, telfast.
With rapid development, 0.1% adrenaline solution and 3% prednisolone solution are injected subcutaneously.

Why is it important to see a doctor

If symptoms develop, you should definitely see a doctor.

This is a very dangerous disorder that can lead to swelling of the larynx and pose a real threat to life.

Only timely medical assistance will be able to stop the symptoms of pathology and prevent the appearance of serious complications.

Quincke's edema is an extremely dangerous disease that can be fatal. Therefore, after eliminating the threatening condition, it is imperative to undergo a comprehensive examination in order to identify the allergen.

Angioedema, or otherwise - Quincke's edema was first described in 1881, since then many studies have described its symptoms. Its treatment is carried out both by non-drug methods and by pharmaceutical preparations. Quincke's edema is a swelling of the epithelium, subcutaneous tissue and submucosal membranes. The development of edema occurs extremely quickly and in an acute form.

Quincke's edema, the symptoms and treatment of which depend on the true origin of the pathology, is classified as follows:

Hereditary form of angioedema (HAE).
Acquired angioedema (PAO).
Allergic angioedema.
Angioedema of non-allergic origin (in the absence of C1 inhibitor pathology).

Classification of the types of Quincke's edema makes it possible to systematize the characteristics of the symptoms of each type and choose a treatment method. Very often, without sufficient knowledge, patients confuse true Quincke's edema with urticaria. Although the latter pathology accompanies only 1 type of edema, which is treated quite simply. The most difficult form of edema is hereditary.

It, in turn, is divided into subcategories:

Hereditary forms of AO are not accompanied by urticaria. They are initially diagnosed at a very early age and subsequently recur systematically.

Acquired angioedema (PAO) is less common. It usually occurs with malignant neoplasms, chronic infectious diseases and autoimmune pathologies. The first manifestations occur already in adulthood (45-50 years) with subsequent systematic relapses.

Quincke's edema (symptoms and treatment are mistakenly attributed to urticaria by many) in allergic forms has a completely different etiology. Allergic angioedema in this case is due to hypersensitivity to certain allergens. As a result of this factor, there is a local expansion of the vessels of the epithelium, and the degree of permeability of the vascular walls also increases.

This leads to cell migration and edema occurs in the deep layers of the epithelium. AO with a non-allergic development mechanism should be distinguished as a separate form. This pathology is associated with malfunctions of the body's immune system. Basically, these are violations in the complementary system, which counteracts foreign agents and is responsible for the formation of inflammation and manifestations of allergies.

When its activity is activated, the same processes occur as in the allergic form, but they are not caused by the activity of allergens.

In the scientific literature, a vibrational form is described separately, which arises against the background of vibrations, moreover, even insignificant ones.

Causes of development in children and adults

Angioedema is a pathology caused by numerous factors. Their reasons should be considered with reference to the classification. As mentioned above, hereditary forms are based on genetic factors. The causes of PAO are infectious, oncological and autoimmune pathologies.

The allergic form is characterized by binding to the action of certain groups of allergens:

various chemicals;
Food;
pharmaceuticals;
pollen of plants;
insect bites.

The formation of Quincke's edema at a normal level of the inhibitor and its functional characteristics (edema of non-allergic origin) has its own characteristics. Regulation of the activity of the complementary system occurs due to the variation in the level of the C1 inhibitor.

With an excess of it, the activity of the system slows down, and with a lack of it, it has a positive trend. Scientific developments have established that a decrease in C1 levels is a source of Quincke's edema of non-allergic etiology. The reason lies in the increase in histamine levels.

Its increase occurs as a result of consumption in large quantities:

guilt;
cheese;
beer;
other types of alcohol;
smoked meats;
chocolate;
fishes;
tomatoes;
spinach;
certain groups of pharmaceuticals (antibiotics, muscle relaxants, general anesthetics, narcotic analgesics);
iodine preparations in radiology;
ACE inhibitors.

The following group of factors provokes the onset of the disease:

In addition, AO can be associated with pathologies:

nervous system;
of cardio-vascular system;
gastrointestinal tract;
respiratory organs;
genitourinary system.

The mechanism of edema formation

Partially the scheme of edema occurrence has already been described above. They begin to form as a result of the expansion of the vascular lumen, an increase in the volume of blood vessels and, as a result, an increase in the permeability of the vascular walls. As a result of free cell migration, zones of edema are created.

The development of edema occurs rapidly (from several minutes to several hours). Edema is localized in the eyelids, lips, next to the genitals, on the distal surfaces of the extremities, on the submucosal membranes of the respiratory and gastrointestinal tract.

The first symptoms of angioedema

Quincke's edema, the symptoms and treatment of which are described in dozens of sources, does not always fit the standard description. Therefore, at the onset of an exacerbation of the disease, it is important to notice the first manifestations of edema in time, since the situation can develop very quickly.

On the face

Localization of edema on the face is typical for all forms of AO. Seals are in most cases located around the eyes, close to the eyelids, around the lips. With massive edema, phenomena of temporary loss of vision may occur due to compression of the eyelids.

Edema located in the lip area can spread to the mucous membranes of the mouth, pharynx and larynx. In this regard, they pose the greatest danger.

In the respiratory tract

With the defeat of the respiratory system, edema covers the areas of the lips, pharynx, tongue and just above the larynx. From the very beginning of the edema, a hoarse voice is observed, as the edema develops, turning into a whisper with wheezing. Barking cough is common. In severe cases, asphyxia and death of the patient is observed.

In the internal organs

As a rule, the gastrointestinal tract is affected in all forms of OA. Manifested by systematic sharp pain due to swelling of the intestinal wall. They are accompanied by anorexia, diarrhea and vomiting. Clinical manifestations are similar to those of "acute abdomen" and intestinal obstruction. With the defeat of internal organs, as a rule, there are no external manifestations.

Endoscopy reveals well-defined edema on the intestinal mucous membranes. Edema of the meninges of the brain manifests itself as severe headaches, in severe cases - signs of cerebral circulation disorders and, in the absence of medical care, can lead to death. Edema of the mucous membranes of the urinary tract is characterized by urinary retention.

On limbs and body

When edema is localized on the distal surfaces of the upper and lower extremities, cyanotic seals appear. Palpation does not leave pits and traces. There may be an itching sensation. Such edema does not pose a threat in itself, but it causes considerable discomfort.

The clinical picture with the development of edema

Symptoms and clinical manifestations of Quincke's edema are well known and allow the doctor to select the correct treatment in a short time. All forms of HAE are characterized by the formation of dense and painless edema of various localization. They can form anywhere on the body or mucous membrane.

Edema of a pale color, palpation does not leave traces. Itching and urticaria are absent.

There is usually no apparent reason for the onset of edema.

However, provocative factors can be:

For NAO is characterized by constant localization of edema with relapses. The development of edema is relatively slow (8-30 hours). Antihistamines are not effective. The frequency of relapses has no stability.

The clinical picture of the course of PAO is identical to that described above, but with distinctive features:

There are symptoms of concomitant oncological and autoimmune pathologies.
The onset of the disease is characterized by a later date.
Not burdened by heredity.

The course of allergic AO is accompanied by urticaria, itching and symptoms of atopic diseases. The area of edema is hot, hyperemia is observed. Painful manifestations are present, with compressed nerves, paresthesia may be observed.

The development of edema is accompanied by a decrease in blood pressure and anaphylactic reaction, as well as bronchospasm. Rapid development and rapid relief with antihistamines is characteristic. Swelling disappears without treatment in 1-3 days.

The differences in the forms of Quincke's edema are shown in the table:

Symptoms	Hereditary forms	Allergic origin
Complicated anamnesis	No	There is
Heredity	There is	Yes
Primary manifestation	In childhood	In young years
Dynamics	Slow course (11 - 36 hours), the beginning of remission after 1 - 5 days.	Rapid development and rapid disappearance.
Provocative factors	Injuries, pressure, stress, infections, medications, surgical procedures, stress, infections.	Contact with an allergen
Localization	Stable location	Unstable
Taking antihistamines	Not effective	Effective
Hives	Absent	Most often present
Painful sensations	In most cases	Usually absent
Laryngeal edema	Present	Not typical

First aid for Quincke's edema

First of all, it is always necessary to call an ambulance brigade. The development of edema can be very rapid and unpredictable.

Before providing medical care:

Sit the victim in a comfortable position, eliminate panic.
If the pathology is accompanied by urticaria, you can give the patient antihistamines. This will ease his condition a little.
Provide good air access and ventilate the room.
Apply a cold compress or ice heating pad (or a plastic bottle) to the area of swelling.
Drinking plenty of fluids is recommended, best of all - still mineral water. If one is not available, then you can add a quarter teaspoon of soda to a liter of water.

In severe cases, it is better not to take any measures that, due to a lack of skills and qualifications, can only worsen the patient's condition.

What to do at home with laryngeal edema?

If you suspect laryngeal edema, even if it is swelling around the mouth and lips, when calling an ambulance, it should be indicated that there is laryngeal edema and the patient is suffocating. In this case, the nearest team will leave on an emergency basis for health reasons. It is impossible to take measures independently, in addition to the above measures. In this case, only qualified medical assistance is needed.

Treatment in the hospital with drugs

The selection of drugs for treatment is carried out by the attending physician after consultation with specialists:

Tactics for the treatment of angioedema:

relief of acute conditions;
prevention in the current period of remission;
long-term preventive measures.

Therapy for hereditary edema involves both non-drug measures and the use of drugs. The former include the provision of respiratory functions by tracheostomy or intubation.

Medicines for HAO and PAO are approximately the same (dosage and choice are made by the attending physician):

The use of an antihistamine group of drugs for HAE is ineffective. Quincke's edema, symptoms and treatment of its allergic form, as well as non-allergic, have features.

Before starting drug treatment:

A hypoallergenic diet is established.
Drugs that can provoke the disease are canceled.
The identified infectious and inflammatory processes are stopped.

The treatment is based on third-generation antihistamines:

Zyrtek;
Allergodil;
Telfast;
Cetrin;
Semprex.
Astemizole;
Terfenaddin;
Loratadin.

Second-generation drugs can also be used:

Cetirizine;
Desloratadine
Rupatadine;
Ebastine;
Fexofenadine;
Loratadine;
Levocetirizine.

These pharmaceutical preparations can be used for a long time. The best effect is noted when using them during remission. First generation drugs are not recommended. The reason is multiple side effects. Glucocorticosteroids are recommended in cases of severe disease. For health reasons, the introduction of adrenaline is recommended.

Diet

Questions related to the diet in each case must be agreed with the attending physician.

In general, try to eliminate the following foods from your diet:

whole milk;
eggs;
citrus;
coffee;
chocolate;
caviar;
smoked meats;
a fish;
mustard;
nuts;
wheat;
tomatoes;
mushrooms;
raspberries;
cocoa;
Strawberry;
spices;
sauces;
beet;
black currant;
carrot;
carbonated drinks;
alcohol.

Most often, a strict diet is introduced for periods of acute condition, and then foods that have a causal relationship with the onset of edema are simply excluded.

Folk ways to relieve edema

In folk medicine, there are many recipes for relieving edema. But without a reliable diagnosis and the recommendation of the attending physician, self-treatment should not be performed.

As an aid, you can use:

These are the simplest and most affordable ways.

Usually the simplest edema does not cause difficulties with treatment. However, in severe cases, it requires serious treatment. Hereditary forms of edema and acquired AO persist for life. Therefore, it is necessary to systematically undergo a course of preventive treatment during the period of remission and follow all the recommendations of the attending physician.

Laryngeal edema is the most dangerous of Quincke's edema. Most often, deaths are associated with this type of attack.

In the presence of an illness accompanied by urticaria, contact with cold water under certain conditions can cause the development of giant urticaria after swimming. In some cases, this ends with the death of the patient. Observations have established that if AO, accompanied by urticaria, has a relapse every six months, then this process will continue for at least 10 years.

There are cases of spontaneous termination of chronic AO, aggravated by urticaria. Most often this applies to children. Quincke's edema is a common pathology with high dynamics and frequent deaths. Therefore, if his symptoms appear, you should immediately contact a medical institution so that doctors can treat him.

Article design: Lozinsky Oleg

Video about Quincke's edema

Quincke's edema. How not to die of allergies:

Quincke's edema is a dangerous allergic reaction with severe symptoms. If first aid is not provided correctly, 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, there is a risk of suffocation. In some patients, swelling of the internal organs develops, and there is a threat to life.

What allergens trigger an acute reaction? What to do with the development of angioedema? How to provide first aid for angioedema? These and many other issues related to a severe allergic reaction are covered in the article.

Causes of a Severe Allergic Reaction

A dangerous condition develops under the influence of stimuli of various kinds. in a quarter of cases, it occurs with a hereditary predisposition to increased sensitization of the body; in some cases, doctors cannot establish the exact cause of the acute immune response. Quincke's edema ICD code - 10 - T78.3.

Provoking factors and allergens:

products of certain groups. In most patients, certain types of food cause a severe allergic reaction: honey, eggs, whole milk, citrus fruits. Red berries, fruits and vegetables, chocolate, seafood, peanuts are also highly allergenic;
household chemicals, washing powders, body care compositions;
potent drugs: iodine-containing agents, sulfonamides, antibiotics, aspirin, B vitamins, formulations with an anticonvulsant effect;
pollen of plants during the flowering period;
poison that enters the body through insect bites;
cosmetic products, especially of a low price category with irritating ingredients;
helminthic invasions;
feather, wool, down 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, lingering stress;
severe autoimmune diseases.

Fundamental rules:

parents should compose the child's diet, taking into account the degree of allergenicity of the products;
you should not feed children with food that contains dangerous synthetic fillers, preservatives, 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 the immune system, be outdoors, harden. An important point is the prevention of passive smoking, which worsens the general condition of households, especially children;
the medicine cabinet should always contain antihistamines. Giant urticaria develops quickly, often within 15-30 minutes. In the absence of an allergy medication at home, serious consequences are possible. Allergy sufferers should always carry an antihistamine prescribed by their doctor.

Symptoms, consequences, causes of Quincke's edema should be known to every person. When signs of giant urticaria appear, the participation of health workers is required. Don't panic: properly provided first aid often saves the life of an adult or child with an acute allergic reaction.

In the following video, useful expert advice on how to provide first aid for Quincke's edema and what can be done before the arrival of specialists: