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Overepidemiology etiology pathological changes in the pathogenesis of clinical manifestations complications of diagnostic laboratory examinations differential diagnosis of treatment Outcomes Prevention
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Allergic purpura syndrome (Allergic Purpura Syndrome), also known as Schonlein-Henoch purpura, capillary bleeding poisoning disease (Hemorrhagic Capillary Toxicosis), is due to abnormal microvascular bleeding caused by systemic disease can affect the skin, joints, gastrointestinal Road and renal corresponding symptoms. The disease more common in children and adolescents.
Diagnosis Back
According to the upper respiratory tract infection, the appearance of skin purpura, and joints, abdominal and renal involvement while the performance of a recurrent feature, you should consider the possibility of this disease. It should be noted, and thrombocytopenic purpura, acute abdomen, glomerulonephritis, rheumatoid arthritis were identified.
Return treatment
1. Remove the cause: including anti-infection, removal of foci, removal of intestinal parasites, avoid the allergic food and drugs.
2. Antihistamines: choice of chlorpheniramine, promethazine, diphenhydramine, astemizole and other drugs orally or intramuscularly. Can also be applied 10ml 10% calcium gluconate injection, 1 or 2 times a day.
3. Corticosteroids: for acute and abdomen, with obvious pain, can rapidly relieve symptoms. Oral prednisone may be given, if necessary, intravenous i


nfusion of hydrocortisone. Short-term treatment (3 to 5 days) after drug withdrawal symptoms, but medication should be tapered long time after the withdrawal.
4. Other: acute period should stay in bed, gastrointestinal symptoms should be fasting. Intravenous infusion of large doses of vitamin C (3 ~ 5g / day). Severe abdominal pain may intramuscular injection of atropine 0.5 ~ 1mg. Bleeding tendency can be used to stop bleeding drugs. Those who have kidney damage.
Etiology Back
The pathogenesis is unknown, may be related to many factors, infection factors, often in the acute infection of the disease, after a certain incubation period and disease, mostly upper respiratory tract infection, hemolytic streptococcus in the main pathogens, but also for Staphylococcus aureus, viruses, and parasitic infections, food allergy, such as fish, shrimp, crab, milk and other variant protein allergy can be induced by the disease, drugs, such as Green streptomycin, sulfonamides, SA preparation and so on. Also possible with the cold, insect bites, pollen, dust exposure and other factors. These factors on the human body with small arteries, veins and capillaries of the inflammatory changes, increased vascular permeability, causing subcutaneous tissue, mucous membranes and bleeding was the vascular organ edema, and a corresponding clinical manifestations.
Pathological changes Back
Blood and skin around the infiltration of lymphocytes and plasma cells, dermal capillaries showed inflammatory changes, exudation, edema, hemorrhage, caused by skin purpura. Intestinal mucosa edema, exudation, and bleeding caused by abdominal pain is the reason. The joint pain is mainly due to swelling around the joints, caused by intra-articular effusion. Glomerular cell proliferation of renal involvement can be seen, focal necrosis, capillary thrombosis, can also be found renal tubular epithelial cell swelling, degeneration, interstitial fibrosis.
Clinical manifestations Back
1 to 3 weeks before onset tend to have upper respiratory tract infection, slow onset, prolonged course, often alternating attack and remission, according to a violation of lesions in different parts, and have different clinical manifestations:
1. Cutaneous manifestations: the majority of the skin purpura as initial symptoms. Often seen in the distal limbs, extensor side, hips back, face and torso while rare, purpura symmetrically distributed in batches appear, sizes, and can be integrated into the film, and even the formation of blood blisters and hemorrhagic necrosis. Purpura can be generally self-limiting within a few days. Can be accompanied by a small number of the eyelids, lips, hand, foot and parts of angioedema or urticaria.
2. Gastrointestinal tract change: after more than skin purpura abdominal symptoms, but also to those of gastrointestinal symptoms as the first. Mainly for the onset of ileus, or persistent dull pain, in Cullen, or the lower abdomen, accompanied by nausea and vomiting, appear in the stool, vomiting, intussusception and intestinal perforation. Abdominal examination may have tenderness, but no muscle tension, and rebound tenderness. If abdominal symptoms as the main performers, known as abdominal allergic purpura (Henoch Purpura).
3. Joint performance: the performance of joint swelling and pain in the limbs to the knee, ankle, elbow, wrist, etc. is more common, often migratory, subside within a few days, can be repeated attack, attack is often accompanied by fever. Outstanding performance by joint symptoms are known as joint-type allergic purpura (Schonlein Purpura).
4. Renal manifestations: renal purpura often occur after changes, manifested as proteinuria, hematuria, urinary tube, some patients may be associated with edema, oliguria and hypertension. Under normal circumstances this disease better recovery of renal damage, leaving sequelae, a few may become chronic nephritis, or uremia. It should be noted occasionally to kidney disease and purpura was not obvious who the main.
In addition extravasated hemorrhage and edema can affect the nervous system, respiratory and other symptoms of the emergence of the corresponding.
Return auxiliary examination
Bleeding time, clotting time, platelet count and function is normal, ESR may be normal or slightly faster. Capillary fragility test in some patients (beam-arm test) positive. Renal involvement may have proteinuria, hematuria, urinary tube.


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