Quincke's edema

The Quincke's edema, also known as Angioedema known, usually refers to sudden painful swellings of the skin. The face, especially the tongue, throat, eyelids and lips, is particularly affected. The swelling usually occurs repeatedly and can be life-threatening in the throat area.

What is Quincke's edema?

Quincke's edema manifests itself primarily as swelling of the eyelids, lips, tongue and throat. At the same time, swelling and irritation can also occur on the mucous membrane, often accompanied by symptoms such as difficulty swallowing and shortness of breath.
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Under the Quincke's edema Doctors understand a sudden swelling of the subcutis. Usually it is clearly visible, painful swellings that particularly affect the face and the mucous membrane of the throat.

Under certain circumstances, however, the genitals or the intestinal mucosa can swell, which is expressed in severe pain. Quincke's edema can persist for up to three days and recur at fairly short intervals.

It occurs in children and adults alike and requires medical treatment especially if the throat and pharynx are affected.

causes

The Quincke's edema often occurs as part of an allergic reaction. Food intolerance or insect bites in particular can lead to the typical swellings.

Usually these are then accompanied by hives. Quincke's edema can also be hereditary. In this case, it is a question of the reduced formation or malformation of a protein that ultimately causes the swelling.

In comparison, however, hereditary Quincke edema occurs significantly less frequently than allergy-related ones. In some cases, the typical swellings also occur, without a direct trigger being recognizable.

Symptoms, ailments & signs

Quincke's edema manifests itself primarily as swelling of the eyelids, lips, tongue and throat. At the same time, swelling and irritation can also occur on the mucous membrane, often accompanied by symptoms such as difficulty swallowing and shortness of breath. The symptoms of Quincke's edema develop gradually.

It usually takes several days for the initially slight reddening to develop into pronounced edema. Accompanying symptoms such as pain and itching appear as the growth grows. The swollen eyelids can cause blurred vision. Those affected then see everything twice, for example, or suffer from a visual field loss on one or both sides.

Lip swelling can lead to serious tissue injury. In addition, the difficulty swallowing can lead to the sick person ingesting too much food or liquid. This can lead to weight loss and deficiency symptoms. If Quincke's edema occurs in connection with an allergic shock, further symptoms can arise.

Fever, shortness of breath, sweating, racing heart. In addition, life-threatening swellings in the throat area can occur. If the edema is treated professionally, it will go away on its own after a few days. Then itching, redness and other skin irritations quickly disappear.

Diagnosis & course

The attending physician can Quincke's edema often already recognized by the characteristic optics. Tissue samples are rarely necessary. A detailed conversation and a look at the medical history can also help with the diagnosis. If Quincke's edema has already occurred in the family one or more times, this can indicate a hereditary disease.

Ultimately, a special blood test can be used to find out whether the individual case is allergic or hereditary Quincke's edema. The edema can usually be treated well. With allergic edema, the trigger must be identified and avoided. If the swelling occurs acutely, it should definitely be treated medically. If the throat and pharynx are affected, it can lead to shortness of breath and, in the worst case, to suffocation. The person concerned should therefore consult a doctor quickly.

Complications

Various complications can arise as a result of swelling of the tongue, eyelids, lips and throat. A swollen tongue often expands to the throat and narrows the airways. In addition, the swelling causes shortness of breath and difficulty swallowing, which under certain circumstances can trigger aspiration.

Swollen eyelids are usually associated with impaired vision and can cause serious injury if the eye tissue is displaced. With swelling of the lips there is also the risk of serious tissue damage. In addition, due to the problems with speaking, the functionality in everyday life is limited. Occasionally the throat and larynx swell in addition to the face. Then there is an acute danger to life.

Further complications arise as a result of allergic shock, which is often associated with cardiovascular problems. During treatment, the use of antihistamines, adrenaline, and anti-inflammatory drugs can cause side effects and interactions. If a trachea incision has to be made due to swelling in the throat, a scar is usually left behind. Occasionally, infections and wound healing disorders occur. The hormone treatment can lead to headaches, fatigue, nausea, vomiting and dizziness. Long-term effects usually do not occur.

Treatment & Therapy

Acute Quincke's edema can be treated very quickly by the attending physician. Precondition for this is the previous precise determination of the cause.

Quincke's edema caused by allergies can be treated with anti-inflammatory drugs. For example, the doctor can inject cortisone preparations, adrenaline, calcium or even antihistamines directly into the vein to quickly relieve the symptoms. If the trigger for the allergic reaction is known, it must be avoided in the future in order to avoid further outbreaks.

In contrast, hereditary Quincke edema cannot be treated with anti-inflammatory drugs. Only intravenous administration of the malformed protein helps here. If breathing becomes difficult due to swelling in the throat, an incision in the trachea may be necessary to prevent the patient from suffocating.

If swelling occurs frequently in hereditary Quincke edema, therapy with male sex hormones can also be considered. These generally increase protein production and can thus prevent painful swellings. Since the administration of hormones usually also has undesirable side effects, this type of treatment should only take place after carefully weighing the advantages and disadvantages.

prevention

The Quincke's edema can be prevented especially if it is an allergic occurrence. If the trigger can be determined, the patient receives an allergy pass and must in future try to avoid the triggering substance (s) so that no more allergic reactions can occur.

Hereditary Quincke edema cannot be prevented directly. However, it is advisable to consult a doctor when symptoms occur and to work out the most effective treatment method possible with him. This can prevent potentially life-threatening conditions.

Aftercare

Quincke's edema usually resolves completely even without special follow-up care. Therefore, there is no need to take any further action. Depending on how severe the edema was and whether the airways were also involved, the patient may be monitored in an inpatient setting. In this way, if the angioedema recurs, rapid action can be taken.

After the first appearance of Quincke's edema, it should be clarified what caused it. This may require detailed research with the patient.Despite a careful search, in some cases it cannot be clarified which stimulus the body responded to by increasing the permeability of the vessel walls.

In all other cases, however, the patient can avoid the trigger in the future in order to prevent the disease from recurring. If it is not possible to reliably avoid the trigger, emergency measures can be discussed with the patient. If it is to be feared that the person affected will be exposed to the trigger again, they can carry glucocorticoids with them as emergency medication in the future. This means you can react more quickly if Quincke's edema should occur again.

You can do that yourself

Quincke's edema is treated primarily by avoiding the causative agent. In addition to medication, dietary measures, massages and alternative treatment methods are also suitable for this. A balanced diet with lots of vitamins and minerals has proven to be particularly effective. High-fat foods, caffeine and alcohol should be avoided. Sugar and highly dehydrating foods should also be avoided, as they can increase the development of angioneurotic edema.

At the same time, stress and physical exertion should be avoided. Affected persons can additionally support the medical treatment by taking various preparations from naturopathy. Aloe vera and sage, for example, are recommended, which have a calming effect on the skin and thus help to reduce the swelling of the angioedema. If the measures do not show any effect, the responsible doctor must be consulted again.

In addition to symptomatic treatment, the cause of the skin changes must always be determined. This is achieved on the one hand with the help of a sick diary, in which the occurrence, severity and accompanying symptoms of the edema are noted. On the other hand, any triggers at work or at home should be considered and gradually eliminated. As a result of this and through the use of the home remedies and self-help measures mentioned, angioneurotic edema can be treated sustainably.