Angioedema
Introduction
Introduction Angioedema (angioedema), also known as giant urticaria, is a localized edema that occurs in the subcutaneous loose tissue or mucosa and can be divided into acquired and hereditary types. The disease can only occur in the glans, but also in the same time as urticaria. Children are prone to glans edema, which is characterized by edema of the foreskin at the glans, which is like a large blisters. But does not affect urination. It often occurs at night, and the itchiness is not significant. It can resolve itself after a few days. Single or repeated in the same area, often combined with urticaria. When there is angioedema in the mucous membrane of the throat, there is nausea, throat discomfort, hoarseness, difficulty breathing, and even suffocation. Generally no systemic symptoms.
Cause
Cause
Causes of angioedema
Acquired angioedema is similar to urticaria and can be caused by factors such as drugs, food, inhalation or physical stimulation. Hereditary angioedema is autosomal dominant, mainly caused by functional defects of C1 esterase inhibitor (ClINH). Skin lesions are localized swelling, unclear borders, skin color or reddish color, bright surface, elastic feeling, mostly single angioedema, occasionally multiple; itching is not obvious, occasionally mild swelling and discomfort. It usually lasts for 1 to 3 days and can gradually subside, but it can also be repeated in the same area.
Examine
an examination
Related inspection
Serum complement C1q serum complement C4 serum total complement serum complement C4 content determination serum total complement activity (CH50)
Blood eosinophils increase and IgE can increase. The lack of C1INH or only inactive C1INH in the serum of patients with angioedema deficient in C1 esterase may be accompanied by abnormal levels of complement components (C1, C4, C2) in the anterior segment of the complement system.
Diagnosis
Differential diagnosis
Vascular edema is easily confused
1. Acquired angioedema: mainly occurs in loose areas of tissues (such as eyelids, lips, tongue, external genitalia, hands and feet, etc.). Skin lesions are limited swelling, the boundary is unclear, the skin color or reddish color, the surface is bright, the touch is elastic, mostly single, occasionally multiple. Itching is not obvious, and occasionally mild swelling and discomfort. It usually lasts for 1 to 3 days and can gradually subside, but it can also be repeated in the same area. Often accompanied by urticaria, occasionally accompanied by edema of the throat caused by breathing difficulties, and even suffocation leading to death. When the digestive tract is involved, there may be symptoms such as abdominal pain and diarrhea.
2. Hereditary angioedema: Most patients start to attack in children or adolescence, often recurrent to middle age or even life, but the frequency and severity of seizures after middle age will be reduced. Trauma or infection can induce the disease. More common in the face, limbs and genitals. Skin lesions are localized, non-recessed subcutaneous edema, often single, consciously not itchy. Can also affect the oral cavity, pharynx, respiratory tract and gastrointestinal mucosa and other corresponding performance. It usually disappears after 1 to 2 days.
