Quincke’s Edema: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate Quincke’s edema (angioedema):

Leading symptoms

  • Recurrent edema (water retention/skin swelling) of:
    • Lips
    • Eyelids
    • Tongue
    • Face
    • Larynx (larynx)
    • Extremities
    • Genital
  • Feeling of tension in the affected parts of the skin
  • Pruritus (itching)
  • Painful abdominal discomfort/abdominal cramps → think of: Deficiency or decreased activity of C1 esterase inhibitor (C1-INH).
  • Nausea (nausea), vomiting.
  • Diarrhea (diarrhea)

Possible accompanying symptoms

  • Dysphagia (dysphagia)
  • Dyspnea (shortness of breath) [due toangioedema of the larynx/larynx].

Other notes

  • Usually, angioedema is histamine-mediated angioedema (mast cell-mediated) or idiopathic cases.
  • Bradykinin-mediated angioedema manifests throughout the body, often in the extremities and gastrointestinal (GI) tract.
    • Recurrent abdominal colic of unclear cause + acute ascites → think: hereditary angioedema (HAE) Note: Characterized by episodic skin and mucosal swelling that may occur on the face and frequently on the extremities and gastrointestinal (GI) tract; furthermore, recurrent (reoccurring) abdominal colic, acute ascites (abdominal dropsy), and edema (water retention) that occurs up to twice weekly and, if untreated, lasts approx. 3-5 days.

Hereditary (inherited) angioedema with C1 inhibitor mutation

Prodromal symptoms (precursor symptoms of disease):

  • Fatigue
  • Irritability
  • Fatigue
  • Increased feeling of thirst
  • Erythema marginatum – sharply demarcated, truncal, non-pruritic, pinkish-red rash belonging to erythema (areal redness of the skin).

The following symptoms and complaints may indicate heriditary angioedema:

  • Recurrent edema (recurrence of skin swelling) without pruritus (itching) or erythema (areal redness); and/or
  • Recurrent abdominal pain attacks, with/without vomiting and/or diarrhea (diarrhea).
  • If necessary, with recurrent ascites (abdominal fluid) and or.
  • Recurrent edema of the upper respiratory tract.

Other indications

  • * The edema is usually not pressable!
  • No appearance of wheals
  • Restitutio ad integrum (healing of a disease without permanent damage).
  • Duration of untreated angioedema: 3-5 days (in rare cases hours to 7 days).
  • Note: No response to antihistamines (drug which attenuates or abolishes the effect of the endogenous messenger histamine) and/or glucocorticoids.