Quincke’s edema (another name is angioedema, giant urticaria) is an acute, unexpected, rapidly evolving reaction of the body to chemical and biological factors, most often of an allergic nature. The most obvious manifestation of the disease is an increase in the soft tissues of the face (lips, eyelids, cheeks, oral mucosa), neck, extremities (feet and hands), and genitals.
Quite often (2%) Quincke's edema is diagnosed in children (especially girls), since they are most susceptible to all sorts of allergic reactions. The disease is severe and requires immediate treatment. So all parents whose babies from birth are prone to allergies should know the basic information about it and above all - what causes Quincke’s edema.
To protect your child from angioedema, you need to know exactly what factors are capable of provoking the development of such a rapid and dangerous disease. Depending on the causes, there are several forms of disease.
Allergic angioedema in children
Is a reaction of the immediate type. Direct contact of the child with the allergen provokes the release of mediators (chemicals) from mast cells, leading to increased permeability of submucosal and subcutaneous capillaries with the subsequent development of large-scale edema of soft tissues. The reasons may be:
- food products (eggs, milk, chocolate, fish, berries, citrus fruits, nuts);
- drugs (vitamins of group B, aspirin, iodine drugs, penicillin);
- insect bites;
- many other allergens.
Usually, a child from birth has an allergic reaction to the above factors. If they are not identified in time, not excluded from the life of the baby, the result may be this form of the disease.
Non-allergic angioedema in children
The nature of this form of the disease is somewhat more complicated than the previous one. It is due to the genetic determinism of certain pathological reactions that are inherited according to the dominant type. The causes of non-allergic angioedema in children can be:
- the above factors are allergens;
- childhood infections;
- intoxication of various kinds;
- many physical factors (sunlight, cold);
- condition of the nervous system: for example, stress.
It is more difficult to treat than allergic, but it is much less common.
Recurrent angioedema in children
Very often, despite the timely assistance provided to the child and successful treatment, the disease returns again and again. The development of recurrent angioedema is promoted by such factors as:
- concomitant chronic thyroid pathology (hypothyroidism);
- autoimmune, parasitic or lymphoproliferative diseases (giardiasis, ascariasis);
- liver disease (hepatitis);
- chronic foci of infection (caries, tonsillitis).
For the treatment of the disease to be successful, and the baby’s recovery is fast, it is necessary to identify the factors that provoked this condition. If the cause of the disease remains unspecified (it happens sometimes), idiopathic Quincke's edema is diagnosed in a child who is treated according to a common, standardized scheme. In order for assistance to be timely, you need to know the symptoms of the disease.
Depending on the type of damage to the mucous membranes, larynx, subcutaneous tissue, neurological disorders and abdominal syndrome, the symptoms of Quincke edema in children can be very different.
The defeat of the mucous membranes and subcutaneous tissue:
- puffiness develops rapidly, within 10-30 minutes, lasts from several hours to several days;
- the most common sites of localization of angioedema in children are the lips, eyelids, forehead, cheeks, scrotum, feet, hands;
- if the oral mucosa is affected, the child has difficulty speaking, it hurts him to swallow;
- the tissues are tense, tingling syndrome is noted;
- no pruritus;
- palpation painless, pitting when pressing does not remain.
The defeat of the larynx:
- lightning development;
- the child begins to choke, worry, panic may begin;
- face turns blue;
- there is aphonia (loss of voice);
- when combined with bronchial and tracheal edema, the symptoms very much resemble an attack of bronchial asthma;
- with simultaneous swelling of the nasal mucosa - manifestations of allergic rhinitis.
The rapid progression of angioedema in this case sometimes leads not only to asphyxiation, but also to the death of children, if an urgent tracheostomy is not performed.
- affects the mucosa of the esophagus, stomach, intestines;
- edema of the subcutaneous tissue may not be observed, which complicates the diagnosis of angioedema in children;
- develops suddenly;
- sharp abdominal pain;
- indomitable vomiting;
- profuse diarrhea mixed with blood.
- affects the substance of the brain, its shell;
- epileptiform seizures;
- visual impairment;
- hemiplegia (damage to half of the body part);
- transient aphasia (impaired speech);
- stiff neck.
And other violations (more rare):
- damage to the urinary tract (acute urinary retention, dysuria);
- swelling of the heart (paroxysmal tachycardia);
- affected joints (hydrarthrosis, arthralgia, fever).
If a child is diagnosed with allergic angioedema, most often his face, hands, genitals, feet, mucous membranes of the mouth, gastrointestinal tract, larynx swell very much. The non-allergic form of the disease manifests itself at an early age and is accompanied by severe lesions of the larynx, as well as abdominal syndrome. When identifying the first symptoms, it is necessary to urgently call the doctors, and help the child themselves before they arrive.
A major role in the treatment and progression of the disease is played by first aid for angioedema, which should be timely and correct. It relieves pain and prevents further spread of edema, that is, damage to the vital systems of the body. The sequence of actions at the first symptoms of the disease is as follows:
- Identify the allergen, interrupt the contact of the child with him.
- Soothe the baby.
- Lay it on a flat surface, slightly raising his legs.
- If breathing is difficult, it can be relieved with hot, humid air (take the child to a hot water bath).
- Give the baby a drink of alkaline water as much as possible. This may be a common mineral water, and in its absence - a light solution of baking soda.
- Give enterosorbents (activated carbon, enterosgel).
- If the child is no easier, and the doctor for some reason is delayed, an antihistamine can be given (phenylethyl, for example).
- In the most difficult case, when the baby suffocates and turns blue, you need to self-administer prednisone intramuscularly.
This kind of emergency care for angioedema in children greatly alleviates the condition of the child and further contributes to its speedy recovery without any consequences. But the main treatment for the disease is prescribed by the doctor, and it is inpatient.
After a thorough examination and diagnosis, a course of therapy is prescribed. Usually, treatment of angioedema in children is reduced to taking the following drugs and carrying out procedures.
With allergic forms of the disease:
- first-line drugs - antihistamines (tavegil, ketotifen, claritin, diphenhydramine, suprastin);
- systemic corticosteroids (prednisone, dexamethasone, hydrocortisone);
- diuretics (diacarb, furosemide, lasix);
- askorutin (reduces vascular permeability).
With recurrent angioedema:
- elimination of the source of chronic infection;
- treatment of chronic pathologies of the gastrointestinal tract, biliary tract, liver;
- the introduction of fresh plasma.
With swelling of the larynx:
- inhalation nebulizer therapy with salbutamol, as well as corticosteroid preparations;
- oxygen therapy;
- with an increase in respiratory failure - immediate intubation (or tracheostomy and artificial ventilation of the lungs).
In most cases, allergic angioedema in children develops benign and has a favorable prognosis. Despite this, in practice there is also a relapsing course of the disease, which leads to swelling of the larynx and many internal organs, bronchospasm and even anaphylactic shock. Therefore, at the first symptoms it is necessary to take urgent measures, provide first aid and call a doctor as soon as possible. Only a timely reaction can provide a baby a quick recovery without any consequences for his health.