For most people, the allergic reactions seem somehow unpleasant, but not life-threatening condition. In most cases this is true, but this does not apply to such a dangerous manifestation of allergies as angioedema.
In most cases, angioedema occurs due to the disproportionate reaction of the immune system to some external stimulus. As a result, the body produces a special substance responsible for the body’s response to inflammation – histamines and prostaglandins. These substances increase the permeability of blood vessels, especially small capillaries, and lymph of them begins to flow into the surrounding tissue. So there is an allergic angioedema, which is also traditionally referred to as angioedema.
Angioedema: symptoms, first aid, treatment and prevention
But in fact this name is not entirely accurate. It was given this status due to the fact that earlier it was believed that swelling is caused by dysfunction of the nerves that control the expansion and contraction of blood vessels.
Also found the name “tumor Quincke”that is even more wrong a term, because angioedema is irrelevant to these tumors represent abnormal growth of cell tissues.
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Angioedema was known many centuries ago. But the name was given to him in honor of the German physician Heinrich Quincke, who described the swelling of this type in their patients at the end of the 19th century. He also designed the first effective treatments.
Angioedema can affect many body tissues and internal organs. But the most common swellings appear on the external tissues of the upper body – the face and neck. Often the occurrence of angioedema in the extremities, the genitals.
But especially dangerous oedema angioedema affecting the respiratory system and meninges. They can lead to such serious complications as stroke and suffocation. Without proper treatment, these complications can lead to death.
Edema is the most frequent allergic reaction. The incidence of this syndrome is only 2% of all allergic reactions. However, we cannot say that angioedema is an exotic disease that has little chance to encounter. According to many studies at least every tenth person ever in your life endured angioedema in one form or another.
Angioedema may develop at any age. However, most often it affects young women and children. People who are prone to allergic reactions, more likely to suffer from angioedema. However, this does not mean that swelling may not appear in cases when the person does not fall into the risk group.
The rate of development of angioedema may vary in individual cases. Sometimes swelling develops completely within a few minutes, and sometimes swelling progresses gradually over hours or even days. All depends on the amount of allergen and the duration of its effects. The duration of the edema may also be different. Sometimes the swelling may not take place for weeks, turning into the chronic form. The chronic type includes swelling lasting more than 6 weeks.
Children can be prone to swelling since the very first days of life. In infants it is often provoked by feeding by artificial mixes, and the use of cow’s milk, medicines. As a rule, the disease in the first months of life is more severe than in adults and often ends in death. The children also often observed in the gastric form of angioedema, and form that affect the meninges. Swelling often combined in children with bronchial asthma.
As in the case of other allergic reactions, the syndrome develops in response to intake of allergens. Their can be various substances and agents:
substances contained in foods, especially in nuts and fruits, egg and milk proteins, fish, honey, chocolate, food additives, dyes, flavor enhancers, preservatives, etc.
medicines, particularly antibiotics, anesthetics, vitamins, bromides and iodides, aspirin, some antihypertensives
poisons and toxins, first of all, poisons insects
the household chemicals or industrial chemicals – phenol, turpentine, etc.
dust and dander
microorganisms – fungi, bacteria and viruses
An allergen for each individual can be any substance that is harmless to most other people. However, a particularly strong and rapid allergic reactions develop in response to the action of the poison snakes and insects.
To indirect factors contributing to the development of angioedema include some internal diseases, parasitic infestations, endocrine disorders.
There is also a group of people with a genetic predisposition to the disease. Such people have such swelling may develop regardless of the allergen, for example, with hypothermia or stress.
The symptoms of angioedema
In most cases, symptoms of angioedema is the swelling and increase in size of soft tissues of face, neck and head. In some cases, the face swells so much that begins to resemble a balloon, but instead of the eye slits are left alone or the patient can not open eyes. Sometimes the swelling goes on the hands, especially the fingers, feet, and upper chest.
As a rule, swelling affects all layers of the skin, subcutaneous tissue and mucous membranes. In rare cases, swelling may also affect the joints and organs of the gastrointestinal tract. The last form of edema is observed only upon receipt of the allergens into the stomach with food and medicines.
Angioedema is also sometimes called giant urticaria. However, swelling is more dangerous than the hives and has some differences from it. In particular, unlike hives, the patient is no itching.
Also unlike many other forms of skin allergic reactions, swelling is not accompanied by a rash. When pressing on the swollen place it seems tight and it does not form a pit. Skin color remains unchanged or slight blanching of the skin.
The symptoms of angioedema can also include symptoms suchas reduced blood pressure, tachycardia, and increased perspiration. The mind can become confused, disturbed coordination, restlessness, anxiety and fear.
The most dangerous symptoms are those that indicate the swelling in the upper Airways – trachea, bronchi, larynx, mucous membranes of the pharynx and nasopharynx. If the swelling has moved to these tissues, the patient is threatened with asphyxia.
Such symptoms include barking cough, sore throat, shortness of breath, primarily on the breath, problems with speech. The skin may at first blush and then turn blue. There may be hemorrhage due to small ruptured capillaries of the mucous membranes. The symptoms of angioedema on the mucous membrane of the larynx occur in approximately one fourth of the patients.
However, the absence of symptoms is not an excuse to delay or not pursue treatment, or not to consult a doctor. Because edema may continue to develop, and precious time can be lost.
The symptoms of gastro-intestinal form of angioedema are much like indigestion , acute epigastric pain, vomiting, nausea and diarrhea, or difficulty urinating. In this case, make a diagnosis and prescribe treatment can only a doctor. Edema of the gastrointestinal tract are also dangerous because they can go into dangerous complication – peritonitis.
Swelling of the meninges, is no less dangerous than a swelling of the larynx and trachea. The main symptoms in this case are similar to the symptoms of meningitis. It’s headaches, fear of light and sound, numbness of occipital muscles, which are manifested in the inability to put your chin to your chest. Can also be nausea and vomiting, convulsions, paralysis, disturbances of vision and speech.
The articular form of angioedema are not life-threatening. When it affects the synovial departments of the joints, resulting in pain and decreased mobility.
Angioedema can also accompany urticaria (approximately half of vulchev). This kind of allergic reactions is accompanied by itching, blisters of different size, epiphora and conjunctivitis.
The symptoms of angioedema in young children to recognize it is not easy, but it should be able to all the parents, because for kids this syndrome is particularly dangerous, and the baby is unable to report on what was happening to him.
If the child’s skin appears pale, nasolabial region is blue, the heart beats faster, breathing hard, it means the lack of oxygen associated with laryngeal edema. In the future, the lividity spreads to other areas of the skin, increased sweating. Then may occur suffocation with loss of consciousness and decrease in heart rate.
By itself, swelling of skin tissues and mucous membranes, is not dangerous for life and can pass by itself. However, the complications of angioedema involving the respiratory system and meninges, as well as developing on the background of anaphylactic shock, are extremely dangerous.
Emergency when angioedema
With the development of the above symptoms should immediately call the emergency assistance. If you call for help is not possible, it should attempt to deliver the patient to the doctor themselves. However, any person is able to provide other first aid to the in allergic edema.
The algorithm is the following. First and foremost, the patient should be calm. Bed rest is not recommended. It is better that the patient was in a sitting position. A small child can hold.
If you know the source of Allergy, it is necessary to take all measures to stop ingested. For example, to stop taking food or drugs, leave the place where the allergens spreading through the air.
In that case, if the condition was caused by the insect bite, you should remove the stinger from the wound. So the poison does not spread throughout the body, you should use a tourniquet on the bitten limb above the bite.
Harness to keep no more than 30 minutes. If this cannot be done (the patient was not bitten in a limb), you should apply to the bite the ice or a cold compress.
The same methods should apply in that case, if the swelling developed after the injection of any drug.
To facilitate breathing, the victim needs to remove tight clothing, the tie, unbutton the top two buttons on your shirt or blouse, remove from neck chains, to open the window or put the victim in the room with free access of fresh air.
If the development of the syndrome was the result of the intake of food or medication into the stomach, you should take the sorbents the activated carbon at a dosage of 1 tablet on 10 kg of weight, or smectite enterosgel. Gastric lavage is forbidden, as a possible edema of the larynx the patient may choke on vomit.
Is it possible to reduce the swelling at home? For this purpose, suitable nemedikamentozhnykh very few tools. For example, on a large swelling you can apply cold compressthat would contribute to the narrowing of blood vessels. Also shown to drink plenty of liquids with alkaline reaction , mineral water, soda solution.
But the main means of treatment are antihistamines. It is easier to use antihistamines first generation, such as suprastin, tavegil and diphenhydramine. Despite the fact that they cause drowsiness, the speed of their action is slightly higher than that of other drugs of this class. In most cases it will be enough one tablet.
The principle of action of antihistamines is based on their blocking the impact of histamine to special receptors in the blood vessels. Thus, it stops the growth of oedema, and the patient’s condition stabiliziruemost. For withdrawal from the body of excess fluid diuretics are used. To accelerate the absorption of the drug tablet can be put under the tongue.
It should be borne in mind that even if you take antihistamines led to stabilization of the patient, it is not a reason to cancel the ambulance call. This is especially true in those cases where the cause of allergies is unknown, or the effects of an allergen on the patient’s body to be fully addressed.
In the absence of antihistamines can help vasoconstrictor drugs local action for the treatment of rhinitis (nazivin, Otrivin, rinonorm). A few drops of this drug is required to drip into the area of the nasopharynx and larynx. It should also be borne in mind that antihistamines themselves in rare cases can cause allergies.
But, of course, drug therapy with tablets will be effective only if the patient has no edema of the esophagus and larynx, and he is able to swallow a pill. Often, the swelling can help only subcutaneous or intravenous administration of the drug. These manipulations it is best to do the ambulance workers, with the exception of those cases when being around sick people have enough experience.
In the treatment of angioedema are also frequently used glucocorticosteroid drugs, such as prednisolone (60-90 mg) or dexamethasone (8-12 mg). Hormones shut off the immune response to allergens. Usually these drugs are administered subcutaneously or intravenously, but if it is impossible to make an injection it is recommended to pour the contents of the ampoule under the tongue.
To increase the pressure of subcutaneously injected a solution of vasoconstrictor funds – adrenaline. Commonly used solution of 0.1 % volume 0.1-0.5 ml. measures to increase pressure hold it until the systolic pressure is 90 mm.
In that case, if the patient have already been cases of edema, it is recommended that his family would be ready the drugs for subcutaneous injection.
If the victim will not be provided timely medical care, it may occur asphyxia and apparent death. If not breathing should begin the event on artificial respiration.
Treatment in a hospital
After the arrival of the ambulance medics, depending on the severity of the condition can have a patient on the spot or to be hospitalized. Hospitalization is required for all patients with obvious signs of laryngeal edema. Also this group includes the following categories of patients:
having swelling for the first time
patients with the severe form of the disease
patients with drug edema
patients with abnormalities of the cardiovascular system and respiratory system
SARS recently had a stroke or heart attack
In hospital patients with angioedema are placed either in the Allergy Department or in the intensive care unit or intensive care – in the case of severe, life-threatening condition.
Patients continued using the infusion antihistamine drugs, glucocorticosteroids and diuretics. Also treatments blood purification from allergens using sorbents. Binding of food allergens is carried out using enterosorbents.
In addition to the antihistamines of the first generation can be used with other drugs in this class, which have more complex effects on the immune system and have fewer side effects.
In addition to the introduction of essential drugs, ambulance workers or hospital can also use pure oxygen, and in severe cases, intubation of the trachea.
We live in a world where we are surrounded by millions of different substances and potentially dangerous agents. To avoid them is not always possible, however, such meetings should be kept to a minimum.
For example, trying exotic foods, test preparations, especially when parenteral (intravenous, intramuscular or infusion) administration, the presence of Allergy, to avoid insect bites. You should not take all the drugs and dietary Supplements, especially those that like not really needed, but actively advertised or their friends are taking.
First of all, precautions apply to people with a predisposition to allergies. Special attention should be paid to the composition of pharmaceuticals or food products and to make sure that the components would not be individually dangerous allergens.
But for those who do not have such a predisposition, there are no guarantees. Because the human immune system can change over time, e.g., after acute infectious diseases.
You should also understand that severe allergic reactions such as Quincke edema, is tricky. Sometimes they can not occur after the first contact of the organism with an allergen, and one later, when people might not be ready for such developments.
Therefore, we should always be ready and have the necessary drugs to help deal with the symptoms of allergies, as well as to be able to recognize angioedema, symptoms peculiar to him. Need to know how it turns out first aid for angioedema. Because not in every situation, you can count on rapid medical assistance and speed first aid to the patient may depend on his life.published econet.ru.
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