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Does prednisone make you dizzy. Prednisone Side Effects: Dizziness, Short-Term & Serious Complications Explained

by alexxlab

Does prednisone cause dizziness. What are the common short-term side effects of prednisone. How can prednisone affect your health in the long run. What are the most serious complications associated with prednisone use.

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Understanding Prednisone: A Powerful Corticosteroid Medication

Prednisone is a widely prescribed corticosteroid medication used to treat various inflammatory conditions and autoimmune disorders. While it can be highly effective in managing symptoms, it’s essential to understand its potential side effects, both short-term and long-term. This comprehensive guide will explore the various aspects of prednisone use, including its common side effects, serious complications, and factors that influence the likelihood of experiencing adverse reactions.

Common Short-Term Side Effects of Prednisone

When starting prednisone treatment, patients may experience a range of short-term side effects. These effects are generally mild and often subside as the body adjusts to the medication. However, it’s crucial to be aware of these potential reactions:

  • Dizziness
  • Nausea and vomiting
  • Headaches
  • Increased appetite
  • Weight gain
  • Mood changes
  • Insomnia
  • Blurred vision
  • Fluid retention
  • Acne

Can prednisone cause dizziness. Yes, dizziness is a common short-term side effect of prednisone. This symptom may be more pronounced when starting the medication or adjusting the dosage. If dizziness persists or becomes severe, it’s important to consult with your healthcare provider.

Factors Influencing Side Effect Severity

The severity and occurrence of prednisone side effects can vary based on several factors:

  1. Dosage: Higher doses typically increase the risk of side effects
  2. Duration of treatment: Long-term use may lead to more pronounced side effects
  3. Individual sensitivity: Some people may be more susceptible to certain side effects
  4. Age and overall health: Older adults and those with pre-existing conditions may experience more side effects
  5. Gender: Women may be more likely to experience certain side effects

Serious Complications Associated with Prednisone Use

While short-term side effects are usually manageable, long-term use of prednisone or high doses can lead to more serious complications. It’s crucial to be aware of these potential risks:

Bone Loss and Osteoporosis

How does prednisone affect bone health. Prednisone can significantly impact bone density, especially with long-term use. Studies have shown that up to 40% of patients on long-term prednisone treatment experience enough bone loss to potentially lead to fractures. This effect is most pronounced within the first 6 to 12 months of therapy.

Osteonecrosis, a condition characterized by the death of bone tissue due to reduced blood flow, is another serious complication. This can manifest as hip and knee pain and may require surgical intervention in severe cases.

Cardiovascular Complications

Prednisone use can lead to various cardiovascular issues, including:

  • High blood pressure
  • Irregular heartbeat
  • Electrolyte imbalances (potassium, calcium, and phosphate)
  • Premature atherosclerosis (in medium to high doses)

Are there ways to mitigate cardiovascular risks while on prednisone. Regular monitoring of blood pressure and heart function, along with maintaining a heart-healthy lifestyle, can help reduce these risks. Your doctor may also recommend additional medications or supplements to counteract these effects.

Cushing Syndrome

Prolonged exposure to high levels of cortisol, which can occur with long-term prednisone use, may trigger Cushing syndrome. This condition is characterized by:

  • Redistribution of body fat (especially around the midsection, between shoulder blades, and in the face)
  • Impaired growth in children
  • Skin changes, including thinning and easy bruising
  • Muscle weakness

Gastrointestinal Complications of Prednisone

Prednisone can have significant effects on the gastrointestinal system, increasing the risk of several conditions:

Gastric Ulcers and Bleeding

How does prednisone affect the stomach. Prednisone can increase the risk of gastric ulcer formation, gastritis, and gastrointestinal bleeding. This risk is particularly elevated when prednisone is taken in combination with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. In fact, the risk of GI complications is four times higher when these medications are used together.

Fatty Liver and Pancreatitis

Long-term use of prednisone may contribute to the development of fatty liver disease. In some cases, it can also lead to pancreatitis, a serious inflammation of the pancreas. These conditions require careful monitoring and management by healthcare professionals.

Prednisone and Blood Sugar Regulation

One of the most significant metabolic effects of prednisone is its impact on blood sugar levels. This is particularly concerning for individuals with diabetes or those at risk of developing the condition.

Can prednisone cause high blood sugar. Yes, prednisone can cause an increase in fasting blood sugar levels. This effect is dose-dependent, meaning higher doses are more likely to cause significant elevations in blood glucose. For people with Type 2 diabetes, this can be especially problematic and may require adjustments to their diabetes management plan.

It’s important to note that blood sugar metabolism typically returns to normal after discontinuing prednisone. However, regular monitoring of blood glucose levels is crucial during treatment, especially for those with or at risk of diabetes.

Increased Risk of Infections with Prednisone Use

Prednisone’s immunosuppressive effects can increase susceptibility to various infections, ranging from mild to severe. The risk of developing infections is influenced by several factors:

  • Dosage: Higher doses pose a greater risk
  • Duration of treatment: Longer treatment periods increase infection risk
  • Age: Older individuals may be more susceptible
  • Concurrent use of other immunosuppressive medications

How can patients reduce their risk of infections while on prednisone. Patients can take several precautions to minimize infection risk:

  1. Maintain good hygiene practices
  2. Avoid close contact with people who have active infections
  3. Stay up to date with vaccinations (consult with your doctor about which vaccines are safe during treatment)
  4. Report any signs of infection to your healthcare provider promptly

Musculoskeletal Effects of Prednisone

Prednisone can have significant impacts on the musculoskeletal system, particularly with long-term use or high doses. These effects can range from mild discomfort to severe complications:

Muscle Weakness

How does prednisone affect muscle strength. Prednisone and other corticosteroids can cause muscle weakness, particularly in the legs and arms. This side effect is often dose-dependent and can become severe enough to require hospitalization in some cases. The good news is that this effect is usually reversible upon discontinuation of the medication and implementation of appropriate exercises.

Steroid Myopathy

Prolonged use of high-dose prednisone can lead to a condition called steroid myopathy, characterized by progressive muscle weakness, particularly in the proximal muscles of the upper and lower limbs. This can significantly impact a person’s mobility and quality of life.

Tendon Rupture

In rare cases, prednisone use has been associated with an increased risk of tendon rupture, particularly in the Achilles tendon. This risk may be higher in older adults or those with pre-existing tendon disorders.

Dermatological Side Effects of Prednisone

Prednisone can have various effects on the skin, even at low doses. These dermatological side effects can range from cosmetic concerns to more serious skin issues:

Skin Thinning and Easy Bruising

One of the most common skin-related side effects of prednisone is skin thinning. This can lead to easy bruising and slower wound healing. The skin may also become more fragile and prone to tearing.

Acne and Other Skin Eruptions

Prednisone can trigger or exacerbate acne, particularly on the face, chest, and back. Some patients may also experience other types of skin eruptions or rashes.

Changes in Skin Pigmentation

In some cases, long-term use of prednisone can lead to changes in skin pigmentation. This may manifest as areas of lighter or darker skin, particularly in sun-exposed areas.

How can patients manage skin-related side effects of prednisone. To minimize dermatological side effects, patients can:

  • Use gentle, fragrance-free skincare products
  • Apply broad-spectrum sunscreen daily
  • Avoid prolonged sun exposure
  • Consult with a dermatologist for personalized skincare advice

Prednisone and Ocular Health

Prednisone can have significant impacts on eye health, particularly with long-term use or high doses. Some of the ocular side effects associated with prednisone include:

Cataracts

Long-term use of prednisone can increase the risk of developing cataracts, particularly posterior subcapsular cataracts. This type of cataract can progress rapidly and significantly affect vision.

Glaucoma

Prednisone can cause an increase in intraocular pressure, which may lead to glaucoma in susceptible individuals. This risk is particularly high with topical corticosteroid use near the eyes.

Central Serous Chorioretinopathy

In rare cases, prednisone use has been associated with central serous chorioretinopathy, a condition characterized by fluid accumulation under the retina, leading to visual disturbances.

Is regular eye examination necessary while on prednisone. Yes, regular eye examinations are crucial for patients on long-term prednisone therapy. These check-ups can help detect early signs of ocular complications, allowing for timely intervention and management.

Prednisone and Mental Health

While prednisone is primarily used to treat physical conditions, it can have significant effects on mental health and cognitive function. These neuropsychiatric effects can range from mild mood changes to more severe psychiatric symptoms:

Mood Swings and Emotional Lability

Many patients report experiencing mood swings or increased emotional sensitivity while taking prednisone. This can manifest as irritability, anxiety, or unexplained euphoria.

Depression and Anxiety

In some cases, prednisone use has been associated with the development or exacerbation of depression and anxiety disorders. These symptoms may be more pronounced in individuals with a history of mental health issues.

Insomnia and Sleep Disturbances

Prednisone can significantly impact sleep patterns, often leading to insomnia or disrupted sleep. This can further contribute to mood changes and cognitive difficulties.

Cognitive Changes

Some patients report experiencing cognitive changes while on prednisone, such as difficulty concentrating or memory problems. These effects are usually temporary and resolve upon discontinuation of the medication.

How can patients manage the neuropsychiatric side effects of prednisone. To mitigate these effects, patients can:

  • Communicate openly with their healthcare provider about any mood or cognitive changes
  • Practice stress-reduction techniques such as meditation or deep breathing exercises
  • Maintain a regular sleep schedule and practice good sleep hygiene
  • Consider speaking with a mental health professional if symptoms are severe or persistent

Managing Prednisone Side Effects: Strategies for Patients and Healthcare Providers

While prednisone can be an effective treatment for many conditions, managing its side effects is crucial for ensuring patient safety and quality of life. Here are some strategies that patients and healthcare providers can employ to minimize the risks associated with prednisone use:

Dose Optimization

Healthcare providers should aim to prescribe the lowest effective dose of prednisone for the shortest duration possible. This approach can help minimize side effects while still achieving therapeutic goals.

Alternate-Day Dosing

In some cases, alternate-day dosing of prednisone may be appropriate. This regimen can help reduce side effects while maintaining efficacy for certain conditions.

Bone Health Management

To counteract the bone-thinning effects of prednisone, patients may be advised to:

  • Take calcium and vitamin D supplements
  • Engage in weight-bearing exercises
  • Consider bisphosphonate therapy in high-risk patients

Regular Monitoring

Patients on long-term prednisone therapy should undergo regular check-ups to monitor for potential complications. This may include:

  • Blood glucose testing
  • Bone density scans
  • Eye examinations
  • Blood pressure checks

Lifestyle Modifications

Patients can adopt certain lifestyle changes to mitigate prednisone side effects:

  • Following a low-sodium, potassium-rich diet to help manage fluid retention and blood pressure
  • Engaging in regular physical activity to maintain muscle strength and bone density
  • Practicing good sleep hygiene to combat insomnia

Patient Education

Healthcare providers should ensure that patients are well-informed about potential side effects and the importance of adherence to their treatment plan. This includes instructions on:

  • Proper administration of the medication
  • Signs and symptoms that warrant immediate medical attention
  • The importance of not abruptly discontinuing prednisone without medical supervision

By implementing these strategies, patients and healthcare providers can work together to maximize the benefits of prednisone therapy while minimizing its potential risks and side effects.

Short-Term & Serious Side Effects

Common short-term prednisone side effects include nausea, weight gain and headaches. More serious side effects include fetal toxicity, allergic reactions and high blood pressure. Prednisone side effects are more likely to occur with larger doses or long-term therapy.

Common Short-Term Prednisone Side Effects

Common side effects of prednisone tend to be mild, especially with lower doses and short-term use. They may last a few days to a few weeks. If side effects persist or worsen, talk to your doctor or pharmacist.

Women are more likely to experience prednisone side effects, which can vary in severity and type, depending on a person’s overall health, age and other medications they take.


Common prednisone side effects include:

  • Acne

  • Blurred vision

  • Changes in behavior or mood

  • Dizziness

  • Elevated blood pressure levels

  • Elevated blood sugar levels

  • Fluid retention

  • Headache

  • Increased appetite

  • Insomnia or fatigue

  • Nausea

  • Restlessness and inability to stay still (akathisia)

  • Sleep problems

  • Swelling

  • Thinning skin

  • Vomiting

  • Weight gain

Many people take prednisone with only minor side effects — or none — but each method of taking corticosteroids can present its own unique side effects. In its liquid form, prednisone can cause a sore mouth, sore throat and stomach pain.

Other corticosteroids come as inhalers, as topical creams or as IV fluids. Fluticasone in asthma medications, such as Advair, comes in an inhaler. Hydrocortisone often comes as a cream. Methylprednisolone comes in tablet form, but medical providers can also deliver it intravenously for multiple sclerosis patients.

Serious Prednisone Side Effects

The most serious prednisone side effects usually include allergic reactions, infections, gastrointestinal issues and elevated blood sugar. These may occur when people take larger doses or take the medication for long-term treatment.


Some side effects and what to expect from them include:

Allergic Reactions:
The most prevalent reactions are hives, skin rashes, itching, difficulty breathing, and swelling of the lips, tongue or face. If you experience any of these symptoms, contact an urgent-care provider or your local emergency room.

Bone Loss:
One study showed that up to 40% on a long-term treatment of prednisone have enough bone loss to lead to a fracture. People can also experience osteonecrosis, which is death of bone tissue because of reduced blood flow to the joints. This often manifests as hip and knee pain, but it can become severe and may require surgery. Most people lose bone mass within the first six to 12 months of prednisone therapy.

Cardiovascular Issues:
Prednisone can cause irregularities in potassium, calcium and phosphate levels, potentially leading to high blood pressure and heartbeat irregularities. People who take medium-high doses may develop premature atherosclerosis, a buildup of cholesterol in the arteries.

Cushing Syndrome:
Too much cortisol can trigger Cushing syndrome, which redistributes fat within the body. Signs of Cushing syndrome include the distribution of fatty tissue around the midsection, between the shoulder blades and in the face. Children with Cushing syndrome have experienced impaired growth.

Gastrointestinal Problems:
People who take prednisone increase their risk of developing gastric ulcer formation, gastritis and GI bleeding. The risk is four times higher when someone takes prednisone and an NSAID (such as ibuprofen) together. Other side effects include fatty liver and pancreatitis.

High Blood Sugar:
Anyone who takes prednisone should get their blood sugar tested and monitored while taking it. The drug can cause an increase in fasting blood sugar, a side effect especially serious for people with Type 2 diabetes. Blood sugar metabolism usually returns to normal after the medication is stopped.

Infection Risk:
Taking prednisone can increase the chances of developing mild, serious or life-threatening infections. Larger doses increase the risk, especially doses for immunosuppression. Older age and taking other medications that also suppress the immune system increases the risks. Doses of 10 mg or lower pose the least risk.

Muscle Weakness:
Prednisone and other corticosteroids can cause muscle weakness in the legs and arms. Severe cases may require hospitalization. Stopping treatment and performing exercises usually reverses this side effect.

Skin Problems:
Even at low doses, prednisone can cause skin issues. These include skin thinning, acne, excess hair growth (hirsutism), hair thinning, face redness, stripe-like marks on the skin (stria) and impaired wound healing.

Vision Changes:
Blurry vision is the most common eye problem associated with prednisone, but it’s usually not serious. However, the risk of cataracts in both eyes increases for people who take more than 10 mg of prednisone daily for longer than a year. The drug also increases eye pressure, potentially leading to glaucoma or even permanent damage to the optic nerve.

Fetal toxicity is a valid concern for pregnant women who have a medical reason for taking prednisone. Autoimmune diseases, including lupus, rheumatoid arthritis and inflammatory bowel disease, are potentially more damaging to unborn babies than prednisone.

Researchers hint at a small increased risk of babies being born with a cleft lip or without a cleft palate when their mothers took corticosteroids in the first trimester of pregnancy. But medical providers need much more hard research to document fetal toxicity and other issues, such as a link to gestational diabetes, related to prednisone.

Adrenal Insufficiency

Increased cortisol from prednisone (and other corticosteroids) can cause adrenal glands to shut down, leading to adrenal atrophy (wasting away) and adrenal insufficiency. Adrenal insufficiency is when the adrenal glands don’t produce enough hormones.

The condition leads to Addison’s disease, a life-threatening episode characterized by low blood pressure, low levels of blood sugar and high levels of potassium.


Symptoms of adrenal insufficiency include:

  • Abdominal pain

  • Anorexia or weight loss

  • Body pains

  • Diarrhea

  • Fatigue

  • Fever

  • Headache in the morning

  • Nausea

  • Poor growth and weight gain in children

  • Psychiatric symptoms

Addison’s disease presents when damaged adrenal glands produce insufficient amounts of cortisol or aldosterone.

Mental Health Side Effects

Early in treatment (within several days), prednisone may increase feelings of well-being, anxiety, hypomania or mild euphoria. With long-term therapy, however, people may develop depression. Psychosis, referred to as corticosteroid-induced psychosis, can occur at doses of 20 mg or more per day with long-term use.

Mental health issues start within 3 to 4 days after starting prednisone therapy, but they can occur at any time. Some people continue to have symptoms, including depression, even after therapy stops.

Children who get prednisone for acute lymphoblastic leukemia (ALL), may develop mood fluctuations, depression, manic behavior or euphoria. For most, symptoms go away when therapy concludes.

Prednisone Side Effects in Women and Men

Because corticosteroids, such as prednisone, impact hormones, they can affect men and women differently. Women are more likely to develop osteoporosis, a serious side effect from prednisone use. And women who are pregnant, who want to get pregnant or who are breastfeeding should not take prednisone.

For men, prednisone can cause erectile dysfunction and change testosterone levels. Some men reported reduced sperm counts and infertility.

Men and women experience similar side effects, including depression, mood swings and stomach pain. But overall, doctors need more research to understand the specific role of gender in reactions to corticosteroids.

How to Reduce Your Risk of Prednisone Side Effects

The best thing you can do to minimize side effects from taking prednisone is to maintain a healthy lifestyle. That means eating smart, exercising regularly and getting plenty of sleep.

While taking prednisone, you should avoid smoking and drinking alcohol, and add supplements to your diet.

Once you start on a course of prednisone, pay attention to signals your body sends. Weight gain, fluid retention, nausea, mood swings, sleeplessness and overall weakness are signs to watch. This is especially true for someone on a long-term treatment plan. Exercise helps with fluid retention, depression and high blood sugar.


Tips to help you manage, mitigate and reduce the risk of side effects include:

Fluid retention:
While it might seem counterintuitive, drinking more water helps maintain a proper fluid balance and reduce water retention. But if you notice ankle swelling, speak with your doctor.

Gastrointestinal symptoms:
Take your doses of prednisone with some food in your stomach. If the drugs irritate your stomach, mix in antacids for help.

Infection:
Prednisone and other corticosteroids suppress the immune system, which may need a boost. Stay updated on your vaccines, including an annual flu shot and for long-term vaccines and boosters for shingles, tetanus, pneumonia and COVID-19.

Insomnia:
Before relying on sleeping pills, develop a bedtime routine that includes relaxation techniques, such as guided meditation or deep breathing.

Osteoporosis:
Anyone who takes prednisone should increase their sources of calcium from supplements and food groups to offset bone loss. Peas, beans, lentils, almonds, sesame seeds, amaranth, dark leafy greens (such as collard greens and spinach), broccoli and Brussels sprouts are quality sources of calcium.

Weight gain:
Gaining weight while taking prednisone is a genuine concern, especially because one side effect from the medication is increased appetite. Monitor your food intake and develop a regular exercise routine.

Make time for other things you enjoy: reading, writing, fishing, hiking, dancing, crafting, painting, yoga, Pilates and tai chi can help people find balance. Community centers often have free or inexpensive classes several times a week.

How Prednisone Dosage Impacts Side Effects

Dosage and duration are two aspects of your prednisone prescription that affect the likelihood and severity of side effects.

The higher your dose of prednisone, the more likely you are to notice side effects. The same is true if you must take the medication for longer than 30 days. In fact, most side effects stem from long-term use.

Even if you experience negative side effects, don’t stop taking your prednisone. It is a strong medication, and doctors recommend a gradual step-down approach to end the prescription cycle.

Prednisone Side Effects

Please seek the advice of a medical professional before making health care decisions.

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Does prednisone make you sleepy?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on July 20, 2022.

Prednisone does not usually cause sleepiness but may make you feel dizzy, irritable with mood swings, or cause you to have trouble sleeping (insomnia). If your dose is stopped too quickly or if you take prednisone for a long period of time you may feel severely fatigued. Do not stop taking prednisone unless directed to do so by your doctor. Don’t drive or operate machinery if you feel tired.

Prednisone is often given to treat inflammatory flare-ups of medical conditions such as rheumatoid arthritis, ulcerative colitis, psoriasis, multiple sclerosis, asthma or severe skin rashes. You may feel sleepy or tired while you recover. If your tiredness does not improve, contact your healthcare provider.

What are the most common central nervous system side effects with prednisone?

  • Anxiety

  • Confusion

  • Dizziness

  • Depression

  • Headache

  • Feeling happy or energized

  • “Jittery” or shaky feeling

  • Seizures

  • Trouble sleeping

  • Mood or personality changes

  • Vertigo or a feeling of “spinning”

Call your healthcare provider right away if you have: shortness of breath, severe stomach pain, blood in your stools; black or tar-colored stools, severe depression, severe changes in your personality, mood or behavior; or trouble with your eyes, vision or eye pain.

This is not all the information you need to know about prednisone for safe and effective use and does not take the place of your doctor’s directions. Review the full prednisone product and patient information and discuss this information and any questions you have with your doctor or other health care provider.

References

  • U.S. National Library of Medicine. DailyMed. Prednisone tablet. August 2021. Available at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=03228706-92b9-43c9-8d73-c73aa124c58d&audience=consumer [Accessed May 2, 2022].

Related medical questions

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Medical Disclaimer

Angioedema – causes, symptoms, treatment (first aid, drugs) of angioedema

Causes

Classification

Symptoms

Complications

Diagnosis

Treatment

Prophylaxis

Quincke’s edema, also known as angioedema, is an acute allergic reaction of the immediate type. It is a rapidly emerging swelling of the skin, subcutaneous tissue and mucous membranes in a certain area of ​​the body, most often in the face, neck, genitals. Of particular danger is the defeat of the larynx, which can result in suffocation and death of the patient, as well as swelling of the meninges.

Quincke’s edema requires emergency medical care and often hospitalization of the patient. If there are signs of suffocation, then first of all contact with the allergen is eliminated and resuscitation measures are taken to restore the patency of the airways, then antihistamines, glucocorticosteroids and other drugs are administered.

Reasons

Angioedema is the immune system’s way of responding to exposure to foreign proteins. A special type of leukocytes, mast cells, is involved in its development. When interacting with an allergen, they release biologically active compounds into the blood: histamine, prostaglandins, bradykinin, and others. These substances increase the permeability of blood vessels, due to which the fluid from the bloodstream passes into the surrounding tissues and causes them to swell.

Mast cells are not present everywhere in the body, they are concentrated in the skin, subcutaneous fat, mucous membranes and membranes of internal organs, which explains the damage to certain parts of the body.

Angioedema can be caused by any allergen. More often, the following factors lead to its development:

  • invasive cosmetic procedures involving the injection of a substance;
  • exposure to food allergens;
  • bite of insects or poisonous animals.

    • There is also a non-allergic form of angioedema, inherited at the gene level. As a result of mutations, an absolute or relative deficiency of the C1 esterase inhibitor of the complement system appears, and an increased formation of bradykinin occurs, which increases vascular permeability. An excess of biologically active substances can also be released in the presence of malignant tumors, autoimmune processes, viral, fungal or parasitic infections.

    Classification

    According to the clinical course, Quincke’s edema can be acute, if it lasts from 2 hours to 6 weeks, and chronic, if it lasts more than 1. 5 months.

    More often it appears in isolation, but there is also a form combined with urticaria. Also isolated hereditary angioedema and acquired. It is called idiopathic if the cause of the disease could not be established.

    Symptoms

    Edema occurs suddenly, rapidly, asymmetrically. The skin in the affected area has a pale pink color, the underlying tissues are dense to the touch, painless, when pressed on them, there is no depression left. The patient is rarely worried about itching, more often a feeling of fullness, tingling, burning.

    Symptoms of Quincke’s edema continue to be present from a couple of hours to several days or weeks, after which they usually disappear without a trace.

    With Quincke’s edema, those parts of the body that have a lot of subcutaneous tissue swell:

    • the periorbital region;
    • lips;
    • cheeks;
    • neck;
    • external genitalia;
    • brushes.

    The mucous membranes of the nasopharynx, tongue, larynx, esophagus, intestines, urinary organs are also affected, which disrupts their normal functioning.

    With swelling of the larynx, breathing can be difficult up to asphyxia. The first signs of this process are hoarseness or loss of voice, barking cough. In the future, shortness of breath appears, the skin of the face acquires a bluish tint. The closure of the airway lumen is accompanied by loss of consciousness and, without resuscitation, can lead to death.

    It is more difficult to diagnose an isolated lesion of the digestive organs. With it, severe abdominal pain, vomiting, diarrhea or constipation, flatulence, an admixture of blood and mucus in the feces can be observed, which requires care from the doctor and his ability to distinguish the symptoms of angioedema from surgical pathology and manifestations of poisoning.

    Meningeal edema leads to severe headaches, neck muscle tension, convulsive seizures, nausea, and vomiting.

    Complications

    In addition to asphyxia in the case of damage to the larynx, the disease can lead to other serious complications. Since the liquid leaves the vessels in a significant amount, the volume of circulating blood in them decreases, and as a result, the work of the myocardium suffers.

    Quincke’s edema in adults prone to cardiac pathologies can cause arrhythmia and be fatal. The pathological process in other internal organs with a pronounced violation of their function may be accompanied by the development of coma, renal failure, the picture of “acute abdomen”.

    Diagnosis

    In all cases of angioedema, consultation with an allergist is indicated. Diagnosis of the classical form of the disease with localization on the face, neck, limbs does not cause difficulties due to characteristic symptoms. It is more difficult to identify Quincke’s edema with an isolated lesion of the internal organs or the brain. To do this, it is necessary to conduct laboratory tests, and sometimes instrumental studies.

    To determine the cause of angioedema, the doctor takes a history, specifying the presence of similar allergic reactions in close relatives, the circumstances of the onset of symptoms and their relationship to medication, food, use of cosmetics, insect or animal bites.

    It is also necessary to find out if the patient had any autoimmune or oncological disease, whether he is taking angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, estrogens.

    Laboratory diagnosis of the disease includes the following tests:

    1. Clinical blood test. With angioedema caused by allergies, the number of eosinophils is increased.
    2. Biochemistry of blood. Analysis is necessary to assess the work of internal organs.
    3. Determination of the level of total IgE in the blood. Its increase testifies in favor of the allergic nature of the development of edema.
    4. Skin tests. Allows you to identify the allergen that caused the swelling.
    5. Determination of the concentration and functional activity of the components of the compliment system. A decrease in the C1 inhibitor indicates a hereditary factor in the development of the disease.
    6. Genetic study, the purpose of which is to search for mutations in the C1NH gene. It is carried out with a burdened family history for the early detection of hereditary Quincke’s edema.

    According to indications, ultrasound of the abdominal organs, gastroscopy, examination of feces for dysbacteriosis, and with swelling of the larynx, laryngoscopy can also be recommended.

    Treatment

    With Quincke’s edema, in the vast majority of cases, emergency hospitalization in the ENT, allergological or therapeutic department is indicated, and resuscitation may be required if complications develop.

    First aid

    What to do with Quincke’s edema, you should find out in advance so as not to get confused at a critical moment and help the person before the doctors arrive. The disease can have severe and life-threatening consequences, so you should immediately call an ambulance team. If the allergen that provoked such an immune response is known, it is necessary to break the contact of the patient with it as soon as possible.

    First aid for angioedema includes the following measures:

    • in case of an insect or animal bite, a pressure bandage is applied to the affected area;
    • when the reaction has occurred after an injection of the drug, cold is applied to the injection site;
    • when symptoms are localized on the face, neck, swelling of the larynx, clothes are unbuttoned, you also need to open the window;
    • in case of ingestion of the allergen, you can drink a sorbent, such as activated charcoal or Smecta.

    The development of Quincke’s edema in children is accompanied by a restless state of the child, screaming and crying, which, in case of manifestations of the disease on the face and in the larynx, can accelerate the onset of asphyxia. Therefore, it is extremely important to calm such a patient and stay close to him until the doctors arrive.

    Inpatient treatment

    Non-drug treatment of angioedema includes a diet containing only foods with a low probability of developing an allergic reaction, limiting the intake of medications that increase the release of biologically active substances into the blood. In case of suffocation, emergency intubation or tracheostomy is performed.

    Angioedema medications are usually administered intravenously or intramuscularly. To stop an allergic reaction, antihistamines, glucocorticosteroids, enterosorbents, solutions to restore the volume of circulating blood, normalize the acid-base and water-electrolyte balance are used.

    In hereditary angioedema, prednisolone and antihistamines are ineffective. In this case, the administration of a C1 inhibitor, fresh frozen native plasma, antifibrinolytic and diuretic drugs, androgens is recommended in the acute period.

    Prevention

    Prevention of angioedema consists in the complete exclusion of contact with substances that cause the development of allergies. Patients with a hereditary nature of the disease are recommended medication preparation before dental procedures and surgical interventions, which should be discussed in advance with an allergist.

    The author of the article:

    Ovsyankina Olga Vladimirovna

    allergist-immunologist

    work experience 11 years

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