Quincke's edema Pediatrics Aarushi Sood.pptx

Quincke's edema

1. QUINCKE EDEMA - ANGIOEDEMA Made by – Aarushi Sood Group – La1-205(2)

2. DEFINITION -  Angioedema is where a part of the body suddenly becomes swollen. Areas of the body commonly affected include: the face – particularly the lips, tongue and eyelids , hands or feet and the genitals. Sometimes the bowel may also become swollen, which can cause stomach pain. Quincke’s edema, also known as angioneurotic uvular edema  is known to be caused by the deficiency of a substance named C1-esterase inhibitor which triggers an allergic reaction, or due to high levels of the inflammatory mediator bradykinin. This condition is a rare type of upper airway angioedema.

3. CAUSES OF EDEMA -  Isolated angioneurotic edema of the uvula can occur due to many causes-  These include trauma, exposure to some compounds by inhalation such as marijuana, administration of general anesthesia, adverse reactions to some medications such as angiotensin-converting enzyme inhibitors, certain infections and in a percentage of cases, hereditary conditions such as C1-esterase inhibitor deficiency. For this reason, it is classified into hereditary and non-hereditary. The basic pathophysiologic mechanism is that of a type 1 or immediate hypersensitivity reaction. Hypersensitivity reactions are mediated by the release of histamine and other molecules which induce inflammation by IgE , an antibody produced by plasma cells in response to an allergen. The result is immediate and profound edema.

4. CLASSIFICATION -  Physical (by the triggering stimulus) -  Adrenergic urticaria Aquagenic urticaria Cholinergic urticaria Cold urticaria Delayed pressure urticaria Dermographism/ dermatographism Exercise-induced anaphylaxis Localized heat urticaria Solar urticaria Vibratory angioedema  Ordinary urticaria  ◦ acute (up to 6 weeks of continuous activity)  ◦ chronic (6 weeks or more of continuous activity)  ◦ episodic (intermittent)  Autoimmune urticaria  Contact urticaria (induced by biologic or chemical skin contact)  Urticarial vasculitis (defined by vasculitis as shown by skin biopsy specimen)  Angioedema 

5. SYMPTOMS -  A patient with Quincke’s edema typically presents with a feeling of rapidly progressing obstruction or a foreign body in the throat.  If the airway is blocked, stridor and obvious throat swelling is observed. Examination shows a swollen but not reddened uvula.

6. DIAGNOSIS -  Quincke’s edema is quite different from uvulitis, which is an infectious condition and is frequently induced by or occurs along with inflammation of the nearby epiglottis.  For this reason, direct visualization of the throat or imaging by neck X-rays should be done as needed to rule out uvulitis.

7. RISKS AND DIFFERENTIAL DIAGNOSIS Individual have high risk of Angioedema if they have: Previous history Allergic reactions Disorder associated with angioedema such as lupus, lymphoma, or thyroid disease Family history or hereditary angioedema

8. TREATMENT AND MANAGEMENT -  Treating angioedema depends on what kind of angioedema you have. For severe allergic reactions, you’ll often have  injectable epinephrine  to carry. You should administer this while calling 911. For allergic angioedema, your provider may suggest antihistamines or steroids. You may get them either in oral (pill or liquid) or intravenous (in the vein) form. If you have a non-allergic drug reaction, your provider will help you find a medication to replace the one that’s causing you to swell . Home remedies include things like using ice to reduce swelling or taking cool showers. These may work best on things like swelling in one place or all over your lip or a cool wet cloth over your swollen eyes. If you have hereditary, idiopathic or acquired C1 inhibitor deficiency angioedema, you’ll probably be referred to a specialist. Some medications that treat or prevent heredity angioedema include: C1 esterase inhibitor (recombinant) ( Ruconest ). C1 inhibitor (human) ( Berinert , Cinryze , Haegarda ).

9. PREVENTION -  If you have allergy-related angioedema, you can prevent occurrences by avoiding the food, medication or other triggers that cause allergic reactions.  If you have non-allergic angioedema as a drug reaction to taking ACEIs, you’ll need to work with your healthcare provider to find another medication. To prevent this disease, one should take care of the following things: Recognizing Allergy as Triggers for Hereditary Angioedema. Managing Stress.  Doing Regular Blood Tests. Taking On-demand medication. Promoting Health and Wellness in HAE Eating healthy Resting enough Walking, and doing physical workout

10. THANK    YOU