angioedema
Introduction
Introduction to angioedema Angiovascular edema (angioneuroticedema) is also known as acute neurovascular edema or Quinche edema. The main clinical features are paroxysmal localized skin or mucosal edema, no pain, no itching and skin color changes. The disease can be seen at any age, but is mostly young. There are two types of acquired and hereditary, the latter being rare. basic knowledge The proportion of illness: 0.13% Susceptible people: no specific population Mode of infection: non-infectious Complications: headache, hemiplegia, epilepsy, diarrhea
Cause
Causes of angioedema
Hereditary factors (20%):
Some patients have a family genetic predisposition. However, regardless of the cause of angioedema, the final pathophysiological mechanism can be caused by increased vascular permeability and excessive exudation of intravascular fluid. Edema in any part can usually disappear within a few days after self-regulation, and drug treatment can accelerate the relief and regression of edema.
Autonomic dysfunction (20%):
Under the influence of mental and physical factors, central and peripheral autonomic dysfunction, such as sympathetic dysfunction or parasympathetic hyperfunction. Edema in different parts is related to the corresponding autonomic ganglion plane. Systemic edema may be related to hypothalamic dysfunction.
Allergic reaction (35%):
Some angioedema may be related to allergies, such as food, drugs or certain substances in the environment can cause angioedema due to allergies.
Cause of disease
1. Food or drug allergy.
2. Autonomic nerve function is unstable, and there is a family genetic tendency.
3. The lesions can be seen under the subcutaneous or submucosal small blood vessels, as well as loose connective tissue edema around the blood vessels.
Prevention
Angioedema prevention
Prevent possible causes, prevent infection, strengthen exercise, enhance physical fitness, improve autoimmune function, early diagnosis, early treatment, and actively treat primary disease. Prevention: There are no good measures. If there is a hereditary syndrome background, preventive measures include genetic counseling, carrier genetic testing, prenatal diagnosis and selective abortion.
Complication
Angioedema complication Complications, headache, hemiplegia, epilepsy, diarrhea
Acquired angioedema can cause severe laryngeal edema can cause difficulty breathing or even suffocation. Angioedema can cause edema of the brain, causing headache, hemiplegia, epileptic seizures and other central nervous symptoms, hereditary angioedema such as digestive tract involvement. Abdominal cramps and watery diarrhea, occasional edema in the throat or throat, muscles, bladder, uterus and lungs.
Symptom
Symptoms of angioedema edema Common symptoms Angioedema edema Traveller edema Wind sputum Pre-pressure edema dyspnea Difficult limbs Non-concave edema Sound hoarse upper lip hypertrophy Dysphagia Aspirin allergy
1. The disease can be seen at any age, but mostly in youth. Pre-existing symptoms such as general discomfort, chills or fever may occur before the onset of the disease. Acute onset, peaking in minutes or tens of minutes, lasting days or tens of days. It can be completely relieved without treatment, but it can cause serious consequences when it occurs in important areas. More often manifested as recurrent episodes, some cases can not relapse for a long time, without any symptoms and signs during the interval.
2. It often occurs in a single part, but it can also occur in multiple parts at the same time. Most of the lesions are located in the face, neck, head, upper or lower limbs, and can also occur in the conjunctiva, retina, throat, mouth, genitals, digestive tract and kidneys. The diseased skin and subcutaneous tissue are thickened, the boundary is unclear, the pressure is hard, but there is no finger indentation, the skin color and temperature are normal; in addition to feeling swelling or thermal sensation, there is generally no paresthesia such as pain and itching. Hair loss can occur locally in the elderly. Special serious symptoms can occur in special parts. If it occurs in the mucous membrane of the throat, it may cause difficulty in breathing, difficulty in swallowing, and severe edema of the mucous membrane of the throat may cause suffocation and death.
3. Chronic angioedema has a family heredity, which occurs in early childhood and is progressively progressive, often involving the respiratory and digestive tract.
Examine
Examination of angioedema
General routine examination showed no abnormal findings. In patients with hereditary angioedema, serum C1 esterase inhibitors, serum C1 and C4 values were found in serological tests. Some patients with acquired angioedema were found to have serum C1 esters by serological examination. Enzyme inhibitors, C1, C2 and C4 values are all reduced, especially in the laboratory:
1. Blood and urine routine examination may have mild abnormalities.
2. Cerebrospinal fluid routine examination and blood biochemical examination are mostly non-specific.
Other auxiliary inspections:
1. Most of the head and limb imaging examinations are normal results.
2. Autonomic nerve function test, with auxiliary diagnosis and differential significance.
Diagnosis
Diagnosis and differentiation of angioedema
diagnosis
Diagnosis can usually be made based on medical history and typical clinical manifestations.
Differential diagnosis
The disease sometimes needs to be differentiated from other types of edema of the skin, such as contact dermatitis in the eyelids, which may resemble angioedema in the early stage, but soon there will be papular, blisters and scars such as acne, due to insect bites, thorns. Acute wheal-like reactions caused by sputum or secondary cellulitis, in addition to local swelling, there are redness, fever and tenderness to identify.
