Under hemorrhagic vasculitis understood disease development in which predominantly affects the capillaries of the joints, skin, kidney and gastrointestinal tract.The occurrence of hemorrhagic vasculitis is possible at any age, but it is rarely diagnosed in children under the age of 3 years. disease can begin after 1-4 weeks after suffering SARS, scarlet fever, sore throat or other infection .Hemorrhagic vasculitis - symptoms, diagnosis and treatment of disease.
Causes of hemorrhagic vasculitis
In some cases the disease is preceded by the development of drug intolerances, vaccinations, trauma, food allergy, cooling.The main reason is the presence of hemorrhagic vasculitis, increased production of immune complexes, detection of activation of the complement system, increase vascular permeability, damaged walls of capillaries.
Manifestations of hemorrhagic vasculitis
1. Most of the children for the start of hemorrhagic vasculitis characterized by the appearance of typical skin rash submitted melkopyatnistymi, symmetrically arranged sinyachkovymi elements do not disappear when pressed.The most common hemorrhagic vasculitis occurs in children between the ages of 4 and 12 years old.The main places of localization of the rash are extensor surface of the extremities, buttocks, around the joints.Less often happens that appear rash of the trunk, face, feet and hands.The rash of intensity is different: possible as single or multiple elements with a tendency to merge.When the rash fades, there is pigmentation.If the disease has frequent recurrences, the rash appears on the site of peeling.
2. second characteristic manifestation of hemorrhagic vasculitis is a joint disease. As a rule, it appears, along with a rash illness in the first week or at a later date.The joints may appear as short joint pain and inflammation.Predominantly affects large joints, especially the knee and ankle.In addition, there is the development of edema okolosustavnogo a change in the shape and appearance of painful joints;pain may persist for several hours to several days.There are no resistant strains of joints when their function is disrupted.
3. third characteristic manifestation of hemorrhagic vasculitis is the occurrence of abdominal pain. from some patients complaints on the occurrence of mild abdominal pain that accompanies indigestion that does not cause much suffering.From other patients can hear complaints of pain in the abdomen, which are characterized by the possession of paroxysmal character, the sudden emergence of the type of intestinal colic.They have no clear localization.Perhaps repetition of painful attacks during the day and their duration may be several days.From the patients also received complaints of nausea, vomiting, unstable stool, in some cases - an increase in temperature.Sometimes, on the background of the specified clinical episodes appear gastric intestinal bleeding.
4. much less compared to other manifestations of the disease can be observed damage to the kidneys in hemorrhagic vasculitis.Much less is revealed damage other organs: the occurrence of pulmonary syndrome, hemorrhagic pericarditis, bleeding into the endocardium.
diagnosis of hemorrhagic vasculitis
in hemorrhagic vasculitis changes in laboratory parameters are nonspecific.May increase the ESR and white blood cells, non-specific indicators characterizing the inflammation - DPA, seromucoid, identify Dysproteinemia with higher levels of alpha-2-globulin, C-reactive protein, and titles antistreptolysin About antigialuronidazy.In the diagnosis of hemorrhagic vasculitis revealed immunological changes, manifested by increased levels of immunoglobulin A, an increase in circulating immune complexes and cryoglobulins, lower levels of immunoglobulin G, complement activity.
Treatment of hemorrhagic vasculitis
Depending on the phase of hemorrhagic vasculitis, the clinical form, severity of symptoms, the nature of the disease is different in nature therapy.In all forms of the disease involves the use of antiagrenatov - chimes trental .If during severe hemorrhagic vasculitis, in order to enhance the antiplatelet effect provided for the appointment of two drugs at the same time.
duration of treatment of hemorrhagic vasculitis depends on the severity of the disease and the clinical form and may be from 2-3 to 12 months.If a chronic course of the disease, the treatment is carried out repeated courses over 3-to 6 months.
dose of anticoagulants adjusted individually, based on the positive dynamics of clinical symptoms (stabilization of skin rash, abdominal pain disappeared, reducing the degree of isolation of blood in the urine), laboratory parameters.
In addition, the treatment of hemorrhagic vasculitis appointed activators of fibrinolysis - nicotinic acid and its derivatives.In severe disease are effective steroids .Treatment is carried out against the background of corticosteroids anticoagulant-antiplatelet therapy.Appointment of cytostatics advisable in severe forms in which the kidneys are affected, if there is no positive dynamics of treatment with corticosteroids, as well as in case of severe cutaneous syndrome with the presence of areas of necrosis of the skin, occurring against the backdrop of high immunological activity.
Plasma substitutes Solutions (drip)
In the acute phase of the disease in children with severe hemorrhagic vasculitis held transfusion therapy for 5-15 days.Transfusion therapy involves the use of low-molecular solutions PLASMA ( reopoliglyukina, reoglyumana, reomakrodeksa ) glucose-novocaine mixture antispasmodics, proteolytic enzyme inhibitors.The drug is administered the drip.Plasmapheresis
aims to remove toxins from the circulation, bacteria, inflammatory substances, antibodies, immune complexes, cryoglobulins.It is shown that if during severe hemorrhagic vasculitis, continuous or undulation present recurrence of symptoms.Plasma exchange helps to ensure that the properties of normalized blood starred spasm of blood vessels, improve microcirculation, increased functional activity of immune cells, the sensitivity of patients to drugs.
Antihistamines for vasculitis
Effective use of antihistamines in children with a history of present food, drug or household allergy manifestation of exudative-catarrhal diathesis, allergic diseases.Can be used suprastin, tavegil, diazolin, Phencarolum and other preparations for 7 10 days.
Enterosorbents for vasculitis
In enterosorbents need patients with allergic history, if there is pain in the abdomen, as well as in cases where food agents acted as a provoking factor of the disease.
Membrane can be assigned to repeat courses if kidney disease is detected or relapsing within cutaneous syndrome.Drugs in this group do that decreased vascular permeability, improved trophic processes, they are characterized by the possession of immunomodulatory effects.