Angioedema - Causes, Symptoms and Treatment .MF .

Angioedema (other names - acute angioedema, angioedema, trofonevrotichesky edema, angioedema) - it develops suddenly limited or diffuse swelling of the subcutaneous adipose tissue and mucous membranes.Angioedema and susceptible adults and children, but often the disease occurs at a young age, particularly in women.In children and the elderly is rare.

reasons angioedema

Underlying allergic edema is an allergic reaction to the antigen-antibody complex.Evolved into a pre-sensitized body of biologically active substances - mediators (histamine, kinins, prostaglandins) cause local expansion of capillaries and veins, it is an increase in microvascular permeability and edema of tissues.The cause of edema may be allergic effects of specific foods (eggs, fish, chocolate, nuts, berries, citrus fruits, milk), drugs, and other allergens (flowers, animals, insect bites).

Patients with nonallergic angioneurotic edema disease is caused by heredity.Inheritance occurs dominant type.In patients with reduced serum

levels of C-esterase inhibitors and kallikrein.Angioedema with similar allergic edema develops under the influence of substances that cause the formation of histamine - the same allergens.Swelling develops in the sensitized organism under the influence of specific allergens: flowers, animals, food, drugs, cosmetics, or nonspecific: stress, intoxication, infection, hypothermia.Contributing factors may include liver, thyroid (particularly for its reduced function), stomach, blood diseases, autoimmune diseases and parasitic.Often in this case, the disease acquires a chronic relapsing course.

In some cases the cause of angioedema can not be established (the so-called idiopathic edema).

symptoms of angioedema

disease begins suddenly.Within a few minutes, at least hours, at different parts of the face, and mucous pronounced edema develops.There may be local swelling of lips, eyelids, scrotum and mucous membranes of the oral cavity (tongue, soft palate tonsil), respiratory tract, gastrointestinal tract, urogenital area.Edema is rarely accompanied by pain, most patients complain of a feeling of tension fabrics.In the field of tissue edema observed tension elastic consistency, at a pressure of pits remains, palpation (feeling), painless swelling.

most often angioedema is located on the lower lip, eyelids, tongue, cheeks, throat, and swelling of the throat and tongue can lead to asphyxia - there is difficulty in breathing, develop aphonia, cyanosis of the tongue.

When distributing edema on the brain and meninges appear neurological disorders (epileptiform seizures, aphasia, hemiplegia, etc.).

angioedema can be held for a few hours or days, then disappears, but may recur periodically.

Complications angioedema

most threatening complication can be the development of laryngeal edema with increasing symptoms of acute respiratory failure.The symptoms of laryngeal edema - hoarseness, barking cough, progressive shortness of breath.

swelling of the mucous of the gastrointestinal tract can mimic acute abdominal pathology, thus can be observed dyspeptic disorders, acute abdominal pain, increased bowel movements, sometimes - symptoms of peritonitis.

defeat urogenital system is manifested symptoms of acute cystitis and can lead to acute urinary retention.

most dangerous is localized swelling of the face, because it is possible involvement in the process of the meninges with the emergence of meningeal symptoms or labyrinthine systems that show signs of Meniere's syndrome (vertigo, nausea, vomiting).In the absence of immediate professional assistance such swelling can result in death.

Perhaps a combination of acute urticaria and angioedema.

survey at angioedema

The differential diagnosis is carried out with limfostazom, collateral edema with periostitis, erysipelas, Melkersson-Rosenthal syndrome.The syndrome Melkersson-Rosenthal along with swelling lips chronic course identifies fissured tongue and neuritis of the facial nerve.When erysipelas lips there hyperemia (redness) in the affected area in the form of tongues of flame.

Emergency first aid for angioedema

  • By reducing blood pressure - injected subcutaneously 0.1-0.5 ml of 0.1% solution of epinephrine;
  • When asphyxia (swelling of the airway mucosa) injection of adrenaline;
  • Hormone therapy: corticosteroids (prednisone 60-90 mg / m or / in; deksazon 8-12 mg / in;)
  • desensitizing treatment: antihistamines (suprastin 2% - 2.0 / m, Claritin, Zyrtec, Aerius, Telfast).
  • Diuretics: Lasix 40-80 mg / stuyno in 10-20 ml of normal saline;
  • protease inhibitors Drugs: contrycal - 30,000 IU / in 300 mL of normal saline, epsilon-aminocaproic acid 5% - 200 ml / drip, then - 100 ml in 4 hours or 4 grams per os 4-5once a day until complete relief of the reaction;
  • Detoxification Therapy - hemosorbtion, enterosorption;
  • Hospitalization in allergy department.

phased treatment of edema:

  • Eliminates contact with the allergen;
  • prescriptions to improve the tone of the sympathetic nervous system (calcium supplements, ascorbic acid, ephedrine);
  • decrease in the parasympathetic activity (atropine) and histamine level (diphenhydramine, suprastin, tavegil);
  • needed vitamin - Ascorutinum prescribed to reduce vascular permeability;
  • Showing desensitizing therapy (ACTH, cortisone, prednisone) treatment group B vitamins and gamma globulin
  • mainstay of treatment of hereditary forms of angioedema are medicinal prepraty enhancing products in the body of the missing C1 inhibitor

hormone treatment in the absence of contraindicationshormone therapy is recommended in the hospital.

Prevention

only reasonable prevention is to avoid contact with allergens.

therapists Naumenko Œ