UNIVERSA MEDICINA
Univ Med 2025.
44:84-89
pISSN: 1907-3062 / eISSN: 2407-2230 DOI: https://doi.
org/10.
18051/UnivMed.
CASE REPORT
QuinckeAos disease, a rare clinical disorder: a case report Zikry Mohammad Gifari* * RSUD Majalaya.
Bandung Regency.
Indonesia * Correspondence Author:
gifari73@gmail.
Date of first submission.
September 8, 2024 Date of final revised submission.
February 27, 2025 Date of acceptance.
March 5, 2025 Cite this article as: Gifari ZM.
QuinckeAos disease, a rare clinical disorder: a case report.
Univ Med 2025.
44:84-89
ABSTRACT
BACKGROUND
Quincke's disease, or isolated uvular angioedema, is a rare clinical condition and reports on its etiology and management remain limited.
Most cases are linked to idiopathic conditions, food allergies, airborne allergens, medications (ACE inhibitors.
NSAID.
, hereditary angioneurotic edema, oropharyngeal trauma, and infections.
The disease may be encountered in any emergency setup and must be dealt with rapidly and with utmost vigilance to prevent progression and complications.
CASE DESCRIPTION
A 24-year-old man visited the primary care clinic complaining of sudden throat discomfort upon waking.
described it as the sensation of a round object touching Authe sides of his throatAy.
The sensation persisted despite The patient denied having a sore throat, hoarseness, fever, or cough, and said that he had never experienced similar symptoms.
The patient did not consume anything before he went to sleep and woke up with the sensation that something was 'stuck' in the back of his throat.
Examination revealed an edematous and hyperemic uvula.
Initial management ensured that there was no airway obstruction, with antihistamines and corticosteroids administered to relieve the uvular edema and discomfort.
The patient said that the symptoms subsided within 72 hours and that there was no recurrence.
CONCLUSION
Awareness about this rare but acute condition, even in the background of unknown etiology, in all medical personnel is essential.
Early diagnosis with appropriate management can prevent life-threatening airway obstruction and hypoxemia.
Treatment depends on airway symptom severity.
Thorough examination of each case is crucial, focusing on etiology and definitive management.
Keywords: QuinckeAos disease, etiology, uvular edema, angioedema, airway
INTRODUCTION
Isolated uvular angioedema, also known as Quincke's disease, is a rare form of upper airway Most cases arise from conditions such as idiopathic disease, food allergies, airborne allergens, medications (ACE inhibitors.
NSAID.
, hereditary angioneurotic edema, oropharyngeal trauma, and pharyngotonsillar infections.
prevent airway obstruction and respiratory disturbances, careful monitoring and management are essential.
In 1882.
Heinrich Irenyus Quincke first described acute edema, distinguishing it from The term "angioneurotic edema," initially used by Quincke to describe edema Copyright@Author.
- https://univmed.
org/ejurnal/index.
php/medicina/article/view/1640 QuinckeAos disease, a rare clinical disorder without urticaria or pruritus, was later changed to "Quincke's edema," a synonym for non-allergic .
According to the 2014 Berlin consensus paper by the International Working Group on Hereditary Angioedema, non-allergic angioedema includes hereditary angioedema and acquired angioedema.
The epidemiology of Quincke's disease remains poorly documented.
Over the past two decades, several causes have been studied.
Type I hypersensitivity reactions, triggered by trauma, thermal injury, infection, or drug use .
marijuana, cocain.
, are among the most reported .
Angioedema manifests as localized, asymmetric swelling of skin or mucosa, typically non-pruritic, mainly in areas with loose connective tissue.
Mast cell-mediated angioedema often presents with other mast cell mediator symptoms such as flushing, urticaria, pruritus, rhinorrhea, nasal congestion, bronchospasm, dysphagia, abdominal pain, and cardiovascular .
Conversely, bradykinin-induced angioedema lacks urticaria and other signs of a hypersensitivity reaction.
While antihistamines are effective for mast cell-mediated angioedema .
, bradykinin-mediated angioedema is refractory to antihistamine therapy.
Quincke's disease is not related to hypersensitivity reactions such as skin rashes, hypotension, or tachycardia.
It presents as rapidonset, localized, non-pruritic subcutaneous or submucous swelling.
Kinin and complement pathways mediating type I hypersensitivity are considered possible mechanisms, though idiopathic cases remain unexplained.
Airway management is the primary strategy for Quincke's edema.
Treatment includes monitoring, oxygen therapy, epinephrine when indicated.
H1 and H2 antagonists, and .
Most cases described in the literature are acute episodes managed in emergency departments or outpatient settings with minimal follow-up.
Many cases were successfully managed with medical therapy and had no prior episodes.
Although rare.
QuinckeAos disease can be lifethreatening if the airway is compromised by an enlarged uvula.
Healthcare professionals must remain vigilant and prepared for emergencies in affected patients.
The case is important because of the acute and spontaneous nature of the symptoms and the potential to cause life-threatening airway .
This case report aims to enhance knowledge about the diagnosis and proper treatment of QuinckeAos disease, particularly in addressing its rare idiopathic background and lifethreatening implications.
CASE REPORT
Mr.
S, a 24-year-old man, came to a primary healthcare facility complaining of discomfort in his throat upon waking up from sleep.
The patient also reported an unpleasant sensation in the throat area when breathing, which caused him to wake up from sleep.
He described the sensation as if a round object was creeping and touching the sides of his throat.
The patient attempted to swallow, but the discomfort did not disappear.
The patient denied having a sore throat, hoarseness, fever, or cough, and said that he had never experienced similar symptoms.
The patient did not consume anything before he went to sleep and woke up with the sensation that something was 'stuck' in the back of his throat The patient mentioned a history of allergy to cold The patient has a history of On physical examination: Glasgow Coma Scale E4M6V5 compos mentis, blood pressure 118/78 mmHg, pulse rate 80 beats per minute, respiratory rate 20 breaths per minute, and 7AC.
Examination of the oral cavity revealed hyperemia of the uvula and soft palate of the oropharynx (Figure .
, with edema of the uvula, the uvula appearing elongated, differing from its standard size (Figure .
There were no complaints of stridor, hoarseness .
, or swallowing difficulties.
No laboratory tests or radiological examinations were performed.
To address the throat pain and uvular edema, the patient was given initial treatment with the following oral dexamethasone 2x0.
5 mg, and cetirizine 2x10 mg.
The patient was referred to an ENT specialist.
According to the patient, the symptoms subsided within 72 hours and no recurrence occurred.
Consent was obtained from the patient for the publication of this article and any accompanying Gifari ZM
DISCUSSION