Quincke’s edema, also known as angioedema in technical language, usually refers to sudden painful swellings of the skin. The face is particularly commonly affected, especially the tongue, throat, eyelids, and lips. The swellings usually occur repeatedly and can also be life-threatening in the throat area.
What is Quincke’s edema?
By Quincke’s edema, physicians mean a sudden swelling of the subcutaneous tissue. It usually involves clearly visible, painful swelling that particularly affects the face and the mucous membrane of the throat. However, in some circumstances, the genitals or intestinal mucosa may also swell, resulting in severe pain. Quincke’s edema can last up to three days and recur at fairly short intervals. It occurs in children and adults alike and requires medical treatment especially when the throat and pharynx are affected.
Causes
Quincke’s edema often occurs as part of an allergic reaction. Food intolerances or insect bites in particular can lead to the typical swellings. Usually these are then accompanied by hives. Under certain circumstances, however, Quincke’s edema can also be hereditary. In this case, it is the reduced formation or malformation of a protein that ultimately causes the swelling. In comparison, hereditary Quincke’s edema occurs much less frequently than allergic edema. In some cases, the typical swelling also occurs without a direct identifiable trigger.
Symptoms, complaints, and signs
Quincke’s edema is primarily manifested by swelling of the eyelids, lips, tongue, and throat. Accompanying swelling and irritation may also occur on the mucous membranes, 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 mild redness to develop into pronounced edema. Accompanying symptoms, such as pain and itching, present themselves as the growth of the excrescence progresses. The swollen eyelids can lead to visual disturbances. Those affected then see everything double, for example, or suffer from a loss of visual field on one or both sides. Lip swelling can lead to serious tissue injury. In addition, the difficulty in swallowing can cause the sufferer to take in too much food or liquid. As a result, weight loss and deficiency symptoms may occur. If Quincke’s edema occurs in conjunction with allergic shock, other symptoms may develop. Fever, shortness of breath, sweating, palpitations. In addition, life-threatening swelling of the throat may occur. If the edema is treated professionally, it will disappear by itself after a few days. Then itching, redness and other skin irritations also disappear quickly.
Diagnosis and course
The treating physician can often already recognize Quincke’s edema by its characteristic appearance. Only rarely are tissue samples necessary. A detailed conversation and a look at the medical history can also help with the diagnosis. If Quincke’s edema has already occurred once or several times in the family, this may indicate a hereditary disease. Finally, a special blood test can be used to determine whether the individual case is allergic or hereditary Quincke’s edema. The edema can usually be treated well. In the case of allergic edema, the trigger must be identified and avoided. If the swelling occurs acutely, it should be treated medically in any case. If the throat and pharynx are affected, respiratory distress and, in the worst case, suffocation may occur. The affected person should therefore seek medical attention quickly.
Complications
Various complications can occur as a result of swelling of the tongue, eyelids, lips, and throat. A swollen tongue often spreads to the throat and narrows the airway. In addition, the swelling causes shortness of breath and difficulty swallowing, which may trigger aspiration. Swollen eyelids are usually accompanied by visual disturbances and can cause serious injury if the eye tissue is displaced. Lip swelling is also associated with the risk of serious tissue injury. In addition, due to the problems with speech, functionality in everyday life is limited.Occasionally, the throat and larynx swell in addition to the face. There is then an acute danger to life. Further complications occur as a result of allergic shock, which is often associated with cardiovascular problems. During treatment, side effects and interactions may occur due to the use of antihistamines, adrenaline and anti-inflammatory drugs. If a tracheotomy must be performed due to swelling in the throat, a scar is usually left behind. Occasionally, infections and wound healing problems occur. As a result of hormone treatment, headaches, fatigue, nausea and vomiting, and dizziness may occur. Late effects do not usually occur.
Treatment and therapy
Acute Quincke’s edema can be treated quite quickly by the attending physician. A prerequisite for this is the prior exact 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. Once the trigger for the allergic reaction is known, it must be avoided in the future to prevent further outbreaks. In contrast, hereditary Quincke’s edema cannot be treated with anti-inflammatories. Here, only intravenous administration of the malformed protein will help. If there is difficulty breathing due to swelling in the throat, a tracheotomy may be necessary to prevent the patient from suffocating. If the swellings occur frequently in hereditary Quincke’s edema, therapy with male sex hormones may also be considered. These generally increase protein production and can thus prevent the painful swellings. However, since administering hormones usually also entails undesirable side effects, this type of treatment should only take place after careful consideration of the advantages and disadvantages.
Prevention
Quincke’s edema can be prevented especially if it is an allergy-related occurrence. If the trigger can be determined, the patient receives an allergy passport and must make an effort in the future to avoid the triggering substance or substances so that allergic reactions can no longer occur. Hereditary Quincke’s edema cannot be prevented directly. However, it is advisable to consult a doctor when the symptoms appear and to work out the most effective treatment method with him. This can prevent potentially life-threatening conditions.
Follow-up care
Quincke’s edema usually resolves completely even without special follow-up care. Therefore, it is not necessary to take further measures. Depending on how severe the edema was and whether the airway was also involved, inpatient monitoring of the patient may occur. This allows rapid intervention in the event of a recurrence of angioedema. After the first occurrence of Quincke’s edema, it should be clarified what caused it. It may be necessary to conduct detailed investigations together with the patient. Despite a careful search, in some cases it is not possible to clarify the stimulus to which the body has reacted with increased permeability of the vessel walls. In all other cases, however, the patient can avoid the trigger in the future to prevent recurrence of the condition. If it is not possible to reliably avoid the trigger, emergency measures can be discussed with the patient. If it is feared that the affected person will be exposed to the trigger again, he or she can carry glucocorticoids as emergency medication in the future. This will allow for a quicker response should Quincke’s edema occur again.
Here’s what you can do yourself
Quincke’s edema is treated primarily by avoiding the causative substance. In addition to medication, dietary measures as well as massages and alternative treatment methods are suitable for this purpose. A balanced diet with lots of vitamins and minerals has proven to be particularly effective. Fatty foods as well as caffeine and alcohol should be avoided. Sugar and highly dehydrating foods should also be avoided, as they can increase the development of angioneurotic edema. Accompanying stress and physical exertion should be avoided.Affected persons can additionally support the medical treatment by taking various preparations from natural medicine. For example, aloe vera and sage are recommended, which have a soothing effect on the skin and thus help to reduce the swelling of the angioedema. If the measures do not show any effect, the responsible physician must be consulted again. Accompanying symptomatic treatment, the cause of the skin changes must always be determined. This can be done with the help of a diary in which the occurrence, severity and accompanying symptoms of the edema are noted. Secondly, possible triggers at work or at home should be considered and gradually excluded. By doing so and by applying mentioned home remedies and self-help measures, angioneurotic edema can be treated sustainably.