Purpura

Purpura-What is the purpura?

Purpura is a common form of disease in children with bleeding disorders. Clinically with blood overflow in the skin, mucous membrane under the bruising, petechiae, ecchymosis, pressure does not fade characteristics, often accompanied see epistaxis, teeth bleed, and even then vomiting, bloody diarrhea, blood in urine.

Purpura - Introduction
Change the color of the skin and mucous membrane bleeding purpura purpura purpura general. The clinical manifestations of bleeding, purpura, and ecchymosis, is generally not higher than the leather, only a little bulge in allergic purpura is purple, the pressure does not fade after faded, yellowing to about two weeks subsided . Purpura is the most common clinical manifestations of bleeding disorders, purpura, namely prompt the following may:

1, vascular purpura. Very common, is due to increased vessel wall injury, its fragility and permeability, is common in autoimmune (such as allergic purpura), infection (eg sepsis), abnormal vascular structures (such as hereditary hemorrhagic capillary dilatation) and others (such as abnormal serum protein, simple or senile purpura) disease. Check in addition to the beam arm test may be positive, no other abnormalities.

Platelet abnormalities purpura. The most common, mostly due to thrombocytopenia, increased and dysfunction caused buccal mucosa purpura or blood blister, often prompt serious bleeding, and should actively.

3, coagulation disorders, including coagulation factor deficiency, circulating anticoagulant or fibrinolytic hyperactivity, general bleeding caused by the clotting mechanism, mainly for hemarthrosis, muscle hematoma and internal bleeding, less performance skin purpura, only when the performance of a large ecchymosis, and check the coagulation obvious abnormalities like there to be caused by abnormal vascular purpura and platelet purpura identify. Purpura treatment varies according to etiology.

Purpura - the relevant knowledge
Purpura, allergic purpura syndrome
Allergic purpura medical sub-type and performance
3, purpura and Epstein-Barr virus
4, purpura nephritis in children
5, Idiopathic blood
6 small plates purpura
7, Henoch-Schonlein purpura
8, nephritis, vasculitis, Henoch-Schonlein purpura
9, purpura
10, idiopathic thrombocytopenic purpura
11, idiopathic thrombocytopenic purpura Overview
12, idiopathic thrombocytopenic purpura
13, thrombocytopenia
14, thrombotic thrombocytopenic purpura disease
15 primary thrombocytopenic purpura

Undo edits

B) purpura careFirst, should avoid exposure to induce the disease in all kinds of "errors of the gas, to avoid the diet of fish, shrimp, crab, pollen, milk may trigger allergic purpura nephritis. Secondly, we should pay attention to warm cold, prevent colds, and attention to exercise, enhance physical fitness, and improve the body's resistance to disease. Again, the sick, to bed rest, to avoid excessive troubles, sexual restraint, and cut out alcohol and tobacco. The diet should be nutritious, easy to digest, eat more fresh vegetables, fruits. Hematuria patients should not eat spicy, fragrant dry irritants and seafood fat objects, such as rooster, fish, beef, lamb, goose, etc., so as not to help the heat of the fire, aggravate the condition. Urine protein should be noted that but eat more high protein diet, to prevent the virtual free fill.
(C) the prevention of purpuraIn order to observe the Chinese and Western medicine combined with the treatment of allergic purpura repeated attacks and clinical efficacy of the prevention of renal damage, Rushan City People's Hospital researchers will be 176 cases of allergic purpura were randomly divided into treatment group (treatment on the basis of the control group of conventional Western medicine and Chinese herb soup agent allergy Xiaoban drink 7 to 10 days) and control group before and after treatment to detect urine β2-microglobulin (β2-MG) and serum immunoglobulins (IgA, IgE) indicators, and observation of abdominal pain, joint pain and purpura disappearance of the time. The results of the treatment group, joint pain and purpura disappeared a short time in the control group, the difference was significant, the two groups before treatment and 1 week after treatment of urinary β2-MG and serum IgA, IgE difference was significant after treatment a six months urine β2-MG protein treatment group than the control group, the difference was significant, after a month serum IgA IgE treatment group than the control group, the difference was significant. 0.5-year recurrence rate: the treatment group was 23.5%, 46.2% in the control group, the two groups, the difference was significant. These results indicate that Chinese and Western medicine combined with the treatment of allergic purpura can reduce the recurrence of the purpura and shorter hospital stay, allergic purpura effective in preventing renal damage.
Purpura - purpura, and NO (nitric oxide) correlationPurpura November 14, 2005 Turkish researchers found that NO may play an important role in the pathological process of allergic purpura (HSP), but still needs further research about its pathophysiologic characteristics.
Ankara Gazi University, Division of Pediatric Nephrology Soylemezoglu and his colleagues on the release of NO in children HSP pathogenesis. Of this study is based on NO and urinary nitrate excretion was significantly increased in plasma of children with HSP, this increased significantly with disease activity, and has little to do with the severity of the disease. Soylemezoglu Dr. detection of the 25 children with HSP acute phase and recovery phase, as well as 20 control children plasma nitrate levels in urine nitrate levels and CRP levels.
Compared to convalescence and healthy children of HSP acute phase plasma nitrate levels were significantly increased. Levels of nitrate in the urine was elevated in the acute phase. Therefore, the nitrate levels in plasma and urine related with disease activity, regardless of the severity of the disease. The researchers concluded that, although this experiment show that NO is involved in the pathological process of HSP, but the details still need to further study

.Purpura - Children's winter multiple purpuraPurpura, November 14, 2005: Recently, the temperature suddenly reduce more and more, Children's Hospital Department of Nephrology, allergic purpura patients. Zhu Guanghua, nephrotic medical director of Children's Hospital last year suffering from purpura disease in hospitalized children up to 57 people, accounting for 10.6 percent of the the nephropathy medicine the number of hospitalized children. In recent years, the incidence of allergic purpura is an upward trend.
Henoch-Schonlein purpura is a seasonal disease, whenever the conversion of the season is high season. It is a systemic necrotizing vasculitis, the main pathology of the disease, mainly in children aged 3-10 years. Usually manifested as skin rash, joint pain and gastrointestinal disorders. The most typical symptoms in the limbs, especially limbs of intensive blood-point rash, and a recurring, non-infectious. Allergic purpura attack the light of joint swelling, pain, abdominal pain, severe cases, blood in the stool, vomiting phenomenon, and even the development of intussusception, intestinal perforation. If left untreated, will result in liver and kidney dysfunction, hematuria, proteinuria. Some children will be headache, convulsions, coma, and even lead to a variety of complications, such as: cerebral vasculitis, gastrointestinal bleeding and kidney syndrome.According to the study, allergic purpura, and children with allergic constitution. Composition of bacteria attached to the dust on seafood, animal fur, cold air, pollen and containing antibiotics drugs can cause purpura attack. Dr. Zhu is to remind parents that usually should be a "Kind". Allergic purpura, blood spots appear in the lower limbs or buttocks of children, parents can not be easily found. Bathing the children, many parents inadvertently found before treatment. Symptoms and more abdominal pain, leg pain, vomiting, and parents easy mistake allergic purpura as gastrointestinal problems or arthritis, the results delay treatment. In addition, parents should be prepared to family health, try not to have pets, keep your kids off the dust flying environment. Kids are prone to food allergies, drugs, mind, and to avoid relapse

 

 

 

Purpura - causesThe purpura direct cause of the disease is often difficult to determine the relevant factors:Bacterial infection (upper respiratory tract infections caused by β-hemolytic streptococcus, the most common addition, there are Staphylococcus aureus, Streptococcus pneumoniae, Mycobacterium tuberculosis), viruses (rubella, chicken pox, measles, influenza) and intestinal parasites .Second, food fish, shrimp, crab, eggs, milk and other food heterosexual protein.
Three, antibiotic drugs (cyan, chain, red, chloramphenicol), sulfonamides, isoniazid, antipyretic analgesics (salicylic acid, phenylbutazone, quinine, etc.) and so on.
Other such as cold, pollen, insect bites, and vaccination. The above factors caused by the antigen - antibody complex reaction, this complex deposition in the vessel wall or on the glomerular basement membrane, and activation of complement, release allergens and other damage to the capillaries, arterioles, causing a wide range of capillary inflammation, even necrotizing arteritis, increased vascular wall permeability and fragility, leading to subcutaneous tissue, mucous membranes and internal organs, hemorrhage, edema. Gastrointestinal tract and joints can have a similar change. Kidney disease and more as a focal light nephritis, can have severe glomerular capillary focal necrosis or kidney involvement. Some scholars believe that this disease are rapid onset allergic reactions, a large number of IgE. Adsorption on the mast cells, which release bioactive substances caused the damage.
Purpura - typePurpura, purpura type: The most common, characterized by aseptic inflammation of the dermis layer of the capillaries and small arteries, the blood vessel wall with focal necrosis and platelet thrombus formation. Most of repeated skin petechiae, ecchymosis, most found in the lower extremities and buttocks as the main performance, symmetrical distribution, occur in batches, petechiae of varying sizes, was purple, can be integrated into tablets or slightly higher than the surface of the skin. Was hemorrhagic papules or shape such as measles, may be associated with mild itching. The serious confluent Xuepao to, the center was hemorrhagic necrosis. Petechia, ecchymosis gradually subsided in a few days can also be repeated a few cases may be associated with the eyelids, lips, hands, feet and other limitations of angioedema. Skin purpura symmetrically distributed and occur in batches, recurrent in the limbs and buttocks, especially in the lower limbs extensor side is staggering, a few involving the face and trunk. Purpura appeared skin limbs itching, followed by small hives or red round papules, higher than the leather, the color gradually increase in the depth, showing a purple, pressure does not fade. Severe cases can occur blisters, ulcers and focal necrosis. Individual cases may be associated with nettle and angioneurotic edema, which occurred in the head and face.Abdominal (Henoeh purpura): The main manifestations were abdominal pain, located around the navel or lower abdomen, often has colic or persistent dull pain, with nausea, vomiting, diarrhea, blood in the stool. Serous bloody secretions penetrate the intestinal wall, causing submucosal edema, hemorrhage, causing intestinal irregular peristalsis can cause intussusception. This type symptoms occur before the skin purpura misdiagnosed as acute abdomen.
Third, joint type (Schonlein purpura): In addition to the skin purpura, there are joint pain, and sometimes local tenderness. More common in the knee and ankle joints, intra-articular effusion, but not purulent. Recurrent pain was migratory, may be associated with red, swollen, and movement disorder, usually subside within a few months, the effusion absorbed without leaving any deformity. The event before purpura misdiagnosed as rheumatoid arthritis.
Kidney type: also known as allergic purpura nephritis more common in the juvenile, in addition to skin purpura, but also both proteinuria, hematuria, urinary tube or urine. Small number of cases still oliguria, edema, and hypertension, proteinuria, hematuria, urinary tube, often purpura appeared Zhoufa Sheng, sometimes those extended to 7-8 weeks. Sometimes accompanied by edema, usually recover in a few weeks, have recurrent, persistent for several months by Even a small number of lesions involving the entire kidney and the development of chronic nephritis or nephrotic syndrome, individual occurrence of uremia. Details view of allergic purpura nephritis
Hybrid and rare type: all types of clinical manifestations, if two kinds exist is called a hybrid. While the symptoms of abdominal and joint type is known as Henoch-Schonlein purpura. Such as lesions involving the central nervous system, respiratory system and other corresponding symptoms, a few may have optic atrophy, iris or conjunctival inflammation, retinal hemorrhage.
Purpura - NoteOne, pay attention to rest and avoid fatigue, to avoid mood swings and mental stimulation. To prevent insect bites. Removal of possible allergens,
Keep warm and prevent colds. Control and prevention of infection, use sensitive antibiotics to clear infection or foci, but it should avoid the blind use of prophylactic antibiotics.
The diet of allergic purpura is mostly caused by allergens, raw onions, raw garlic, pepper, wine and other irritating foods should be fasting; meat, seafood, should avoid contact with pollen and other allergens.
Should adhere to consolidate the treatment of a treatment to prevent a relapse, the patient is cured.
Purpura of this disease is self-limiting, usually in 6-8 weeks improved the prognosis is good, in some cases can be recurrent for several years. Renal involvement, most can be restored, a few may develop chronic nephritis, a very small number of deaths due to acute renal failure. Treatment of allergic purpura to eliminate the incentive is more important, and should try to avoid a long time or short-term high-dose injection or oral administration of dexamethasone, triamcinolone acetonide, prednisone and other corticosteroid hormone drug therapy, corticosteroid hormone drugs can make The above condition quickly improved or disappeared; easy to make the disease after discontinuation rebound increase. A long time to give large doses of glucocorticoids can also cause obesity, hirsutism, acne, elevated blood glucose, hypertension, sodium retention, edema, blood potassium decreased, menstrual disorders, osteoporosis, aseptic bone necrosis gastric and duodenal ulcers and other complications. Can also cause some damage to the kidneys, such as increased glomerular diseases, proteinuria, and increased glomerular sclerosis, and prone to cause renal calcification or stones, induce or aggravate renal infectious diseases, causing hypokalemic kidney. Also cause a series of substances the body of sugar, protein, fat and water and electrolyte metabolism disorder, and destroy the body's defense system and inhibition of the immune response. Therefore, if the condition is urgent and must be reasonable under the correct guidance of the specialist applications.If the patient during treatment due to the use of corticosteroid drugs, and hormone dependent, should gradually decrease until the complete removal of the disabled. Disable corticosteroids primary lesions rebound increase and secondary side effects, patients can generate a lot of pain, doctors and family members of patients should do patient ideological work on the removal of the side effects of the disable corticosteroids hormone have a full understanding, enhance their confidence to overcome the disease. And the correct choice of therapy and gradually decrease until the removal of disabled corticosteroids case, the choice of side effects and adverse reactions against the above method and treatment. Achieve the security completely cure the disease. The patient must also bear in mind the allergen, avoid eating or contact with, and to exacerbations.