Why hypostasis arises? In a human body there is a special substance - a histamine. Normal it contains in cages which are called corpulent. They are in connecting fabric, lymph nodes, a spleen and marrow and prove nothing for the time being.
As soon as in an organism the inflammation center arises, corpulent cages receive a signal from other cages, are activated and throw out “charges“ of a histamine and other substances in blood. The histamine causes expansion of capillaries and increases permeability of their walls. It leads to the fact that in the center there is hypostasis, the blood-groove increases and slowed down, so, more and more protective cages (neutrophils and lymphocytes) concentrate. They - that will also help an organism to cope with an inflammation.
occurs also at Quincke`s hypostasis (there is only no the center of an inflammation, and absolutely other factors, sometimes quite harmless provoke release of a histamine). And here corpulent cages release a histamine which causes expansion of capillaries, increases permeability of their walls, as leads to hypostasis of fabrics. At Quincke`s hypostasis deep layers of skin and hypodermic fabrics are involved in process. The small tortoiseshell - the same swelled Quincke on the development mechanism, the top layers of skin are involved only in process. At the same time in the center of action of a histamine vessels extend, connecting fibers bulk up and small congestions of inflammatory cages appear (mainly neutrophils and lymphocytes).
Quincke Swelled can result from realization of three mechanisms: allergic, not allergic and mixed.
- At the allergic mechanism (which is extremely rare for children till 3 years) allergen for the first time comes to the child`s organism at first (in the form of medicine, foodstuff, pollen or poison of insects). The organism takes it for the enemy agent (anti-gene) and makes against it the whole army of immunoglobulins (lgE - antibodies). How guards, are attached by a paling to a membrane (cover) of corpulent cages. At these antibodies good and, the main thing, specific memory: they accurately remember how their anti-gen. looks. In case allergen comes to the second time, it contacts lgE - an antibody on a surface of a corpulent cage that leads to its destruction with emission of a histamine. That is Quincke swelled (as well as any other allergic reaction) develops at repeated hit of an anti-gene.
- At not allergic reaction (which meets at kids much more often) allocation of a histamine happens at impact of any factor (poison of an insect, medicine, food dyes etc.) directly on a wall of corpulent cages.
- Hereditary angioneurotic hypostasis (Quincke`s illness) is carried to the mixed forms. In blood it is real ¬ invisible tell-tales stvut (system of a complement from armor. complementum - addition), which about 20 (01, 02 etc.) . In case of receipt in blood of the alien agent they begin to influence actively at each other. That it was easy to present: at a meeting with “stranger“ the first 01 wakes up and pushes the second 02; that bothers the third 03 (the third sometimes becomes more active without the first two); the third - the fourth, and so - yet is not formed “the heap is small“ which the power punches a cage wall. Actually it is, of course, not tell-tales, and proteins which are in an inactive state. They are also glad to be activated and destroy constantly cages (and not only alien, but also the), but they are disturbed by chiefs (proteins - inhibitors) who constantly suppress their activity.
of the Problem at genetic breakage arise when in blood it is not enough (from 5 to 30% of norm) those terrible chiefs - inhibitor of protein 01 or 03. Protein 01 is in that case glad to try:“ blows rise“ in any unnecessary occasion. The child was cut, suffered prolonged anxiety, overcooled, transferred surgery - the complement is activated and arises Quincke, and often the most adverse option - with throat hypostasis swelled, is more rare - zheludochno - an intestinal path or covers of a brain. At poll it becomes clear that in a family from generation to generation relatives had cases of hypostases of a throat. It allows to suspect the hereditary nature of hypostasis. Fortunately, such cases are very rare.
of the Reason of hypostasis of Quincke
antibiotics, first of all penicillin, acetilsalicylic acid, anticonvulsive preparations, vitamins of group B, iodine preparations, medical serums belong To medicinal substances which can cause hypostasis or urticaria.
of Substance which are added to some drugs - parabens and sulfites, can also cause allergic reaction. These are local anesthetics, bronchodilators, corticosteroids, antibiotics, eye preparations.
Nonsteroid anti-inflammatory preparations can increase sensitivity of skin to a histamine, thus increasing probability of developing of hypostasis of Quincke.
This group of preparations first of all is dangerous by
to the children predisposed to an allergy, or those whose parents have allergic reactions. Any manifestations of allergic states (bronchial asthma, atopic dermatitis etc.) increase danger of development of hypostasis of Quincke at introduction of data of groups of preparations.
many foodstuff or the additives which are contained in them Can cause allergic reaction or directly release of a histamine from cages: dyes and preservatives. For example, a monosodium glutamate, tartrazinovy dye and especially sulfites which are often added to salads, dried fruit, marinades, sausages, sausages, cheese and fruit juice. At “a syndrome of Chinese cuisine“ reaction can arise after the use of exotic species of fish, shrimps and sea salads. Of course, very few people feed kids with similar dishes, but in medicine the cases of hypostasis of Quincke at children caused by a smell of fish are described! Some foodstuff contains the substances releasing an intracellular histamine. Carry strawberry, fish, chocolate, tomatoes, lemons, bananas, egg white to them. Doctors strongly recommend not to give these products to children till 3 years. Other products release nothing, but contain a histamine in large numbers; it is cheese, sauerkraut, sausages. Certainly, from a cheese piece at the healthy child will hardly arise Quincke swelled. Here the hereditary otyagoshchennost (mother, the father or both parents have allergies), non-compliance with a hypoallergenic diet are important during pregnancy (if mother has a predisposition to an allergy), a disease zheludochno - an intestinal path at the kid and many other factors.
Pollen of plants can also serve
as the reason of developing of hypostasis of Quincke. From many thousands of plants on the earth only 50 produce the pollen capable to cause an allergic illness under the name “pollinoz“. Pollinoz (from armor. pollen - pollen) is the disease caused by hypersensibility of an organism to pollen of various plants, at the same time airways, a conjunctiva of eyes, skin suffer. This illness is characteristic of children of more advanced age - from 3 to 9 years. At 11% of the children suffering pollinozy the illness can be complicated by Quincke`s hypostasis. For the European part of Russia in April - May in respect of emergence of a pollinoz (and complications in the form of Quincke`s hypostasis) the blossoming birch, an alder and a hazel grove are potentially dangerous; in June - July - cereals (a herd grass, a hedgehog, a fescue, a ryegrass, a foxtail, a meadow grass, a fire), in July - August - a wormwood, marevy, an orach. In Hugo - east region of Russia in most cases pollen of hemp, marevy, tsiklakhena are the reason of pollinoz. In children often reaction is caused not by one, but a combination of several species of plants. At the same time a half of children has also sensitivity to foodstuff about which it is told above.
Unusual reaction to a sting of an insect can be mediated by IgE - antibodies or is caused by poisons and saliva of an insect which contain a histamine and other substances. And here, of course, an important role is played by predisposition of the child to similar reactions and heredity (if at mother, the father, close relatives hypostasis from stings of any insects was noted, it is better to protect carefully from them the child).
First aid at Quincke`s hypostasis to
From told above it is clear to
that the reasons, from - for whom can arise Quincke, more swelled than there is enough, and not always they can be defined at the first moment. But nevertheless there is a certain algorithm which will help parents to work reasonably before arrival of the doctor. It is necessary to call the doctor at the first symptoms of hypostasis of Quincke even if a condition of the kid satisfactory.
- So, the first that should be made if it is possible, - to stop contact with allergen (to take a sting of an insect, to stop introduction of a preparation), to lay the kid and to raise his extremities. places of a sting or introduction of medicine are higher than
- to impose a plait (in case the sting or an injection were made in a hand or a leg). Back a sting it is possible to put a cold compress.
- to Give to the child plentiful drink of room temperature for improvement of microcirculation and removal of allergen from an organism (to the children of 3 years who do not have metabolism diseases give alkaline drink: 1 - 2% solution of baking soda (1 g of soda on 1 liter of water), Borjomi or narzan). can give to
- For removal of the remains of allergen from an organism sorbents: a suspension of absorbent carbon (to children till 3 years to pound 5 tablets and carefully to mix in a glass of water), to a smekt (1 bag for children till 1 year, 2 bags 2 times a day for children of 2 - 3 years), enterosgel (1 h a spoon for children till 1 year, 2 h a spoon - for children of 1 - 3 years). to Give
- to the child fenistit - an antiallergic preparation in drops (in age doses). Extra care should be observed, giving a preparation to kids till 1 year. If the child was 2 years old, it is possible to give him klaritin (in a dose of 2,5 mg (2,5 ml of syrup or 1/4 tablet), fenkarol (to the child from 2 to 3 years - 0,005 mg).
Attention! Before application of any preparation it is necessary to consult to the attending physician who knows specific features of your child.
- the Doctor of “ambulance“ at emergence of signs of the complicated breath, complexion changes (cyanotic, then pale) will enter Prednisolonum intramuscularly at the rate of 2 - 3 mg/kg of body weight. Usually mother of the child who already had similar states (more often at a hereditary form of a disease) stores Prednisolonum in the first-aid kit. It is necessary to ask in detail the family or children`s doctor on a technique of introduction of a preparation at emergence of the first symptoms of asthma, the doctor has to show to parents as well as where medicine is entered. Recommend to parents for independent introduction intramuscular injections more often.
- Immediately to hospitalize the child for rendering resuscitation actions to it in the conditions of a hospital. Even if all symptoms are stopped on the place, doctors will insist on hospitalization, considering age of the child and need of supervision over it, and also for clarification of the reason which led to development of hypostasis of Quincke.
Diagnosis of hypostasis of Quincke
After knocking over of sharp symptoms will arise need of search of the reasons of developing of hypostasis of Quincke. Before conversation with the doctor remember the next moments which will help the doctor to make the diagnosis:
- allergic diseases in a family;
- the postponed earlier allergic diseases at the child;
- of reaction to drugs (including at mother with the father);
- of reaction to serums, vaccines;
- seasonality of emergence;
- influence of physical factors;
- communication with colds;
- where and when there is hypostasis more often;
- influence of food;
- of contact with animals;
- zhilishchno - living conditions.
For differential diagnostics between Quincke`s hypostasis (allergic or pseudo-allergic reaction) and a hereditary illness important is that at a hereditary form the disease is shown at early children`s age, at family members hypostases of a throat are from generation to generation observed and at the same time allergic diseases in a family are rare, provocative factors are insignificant microinjuries, operation or a stress. In blood the level of C1 or SZ inactivators, treatment by glucocorticosteroids or antihistaminic preparations at the same time is reduced it is inefficient. >
For walk in the wood it is better for p to put on shirts with long sleeves and trousers.
For the allergic reason of developing of hypostasis of Quincke existence of allergic diseases in a family, pathologies zheludochno - an intestinal path or the ENT SPECIALIST - bodies, an error in a diet or the expressed connection with introduction of medicine or a sting of an insect, efficiency of treatment by antihistaminic preparations, and also positive skin tests with allergens are often observed (which are carried out with the diagnostic purpose in the period of lack of displays of an allergy).
the Doctor can appoint by
the following laboratory methods of research during the sharp period:
- Quantitative definition of IgE in blood serum.
- Quantitative definition of specific IgE in blood serum to allergens by means of IFA and the multiple allergosorbentny test.
- Isledovany systems of a complement.
Other researches are conducted by
2 - 3 months later after recovery (time during which in blood enough the corresponding antibodies to allergen appears):
- Carrying out skin tests with allergens. A small amount of estimated allergen or its extract is entered or applied on a skin site on an internal surface of a forearm. Allergens are entered by means of an intracutaneous injection (prick - the test), or into small scratches (the skarifikatsionny test), or drawing directly on skin (the application test). If the patient is sensitive in relation to the studied allergen, then inflammatory reaction develops within 30 minutes.
- Research of an immunogramma (thus the doctor will see that happens to immune system of the child).
At not allergic nature of hypostasis needs the careful inspection including carrying out all-clinical analyses, bacteriological, biochemical research and other methods.