Purpuric nephritis
Introduction
Introduction to purpuric nephritis Anaphyltic purpuranephritis refers to kidney damage caused by allergic purpura. The cause can be allergic reactions caused by infections such as bacteria, viruses and parasites, or allergies to certain drugs, foods, etc., or plant pollen or insects. Biting, cold stimulation, etc. In addition to skin purpura, joint swelling and pain, abdominal pain, blood in the stool, mainly hematuria and proteinuria, mostly occur within one month after skin purpura, and some may also see skin purpura, abdominal pain, and some are only Symptomatic urinary abnormalities. If the protein is lost too much, there may be a manifestation of nephrotic syndrome. If hematuria or proteinuria persists for a long time, it may be accompanied by renal dysfunction, which eventually leads to chronic renal failure. The proportion of allergic purpura causing kidney involvement is 20% to 100%, and male patients are more than female. basic knowledge The proportion of illness: 0.06% Susceptible people: more men than women Mode of infection: non-infectious complication:
Cause
Causes of purpuric nephritis
The cause may be an allergic reaction caused by infections such as bacteria, viruses, and parasites, or may be caused by certain drugs, foods, etc., or caused by plant pollen, insect bites, and cold irritation.
Prevention
Purpuric nephritis prevention
First of all, you should avoid contact with various "unjust qi" that induces this disease, and avoid diets such as fish, shrimp, crab, pollen, and milk that may induce allergic purpuric nephritis.
Secondly, we should pay attention to cold and warm, prevent colds, pay attention to exercise, enhance physical fitness, and improve the body's ability to resist disease.
Once again, after illness, rest in bed, avoid overwork, moderate sexual intercourse, avoid eating alcohol and tobacco, diet should be rich in nutrition, easy to digest, eat more fresh vegetables, fruits, for patients with hematuria, should not eat spicy, fragrant and irritating Animals and seafood, such as cock, sea fish, beef, lamb, goose, etc., in order to avoid heating the fire, aggravating the condition, more urine protein, should pay attention to not eat high-protein diet, to prevent deficiency.
Complication
Purpuric nephritis complications Complication
There may be complications such as rash, arthritis, gastrointestinal symptoms, and high blood pressure.
Symptom
Purpuric nephritis symptoms common symptoms skin purpura edema with proteinuria systemic persistent edema proteinuria blood pressure high hematuria systemic allergy and fever... nausea and vomiting black stool
Renal damage performance
About 40% of patients have glomerular damage, more than 8 weeks after purpura. But it can happen 2 years later, or even before the rash. Kidney damage in allergic purpura is characterized by hematuria, which can be accompanied by mild proteinuria. Clinical manifestations can be as follows: 1 acute nephritis syndrome: about 30%; 2 rapid progressive nephritis syndrome: less common. Progression to uremia in weeks to months; 3 asymptomatic hematuria and/or proteinuria syndrome: about 50% of the disease; 4 nephrotic syndrome: about 10% of adults, more common in children . Five patients can develop chronic nephritis syndrome.
rash
A rash is a skin lesion. There are a variety of manifestations ranging from simple skin color changes to skin surface bulging or blisters. Often the first manifestation of onset, the size of the purpura varies, higher than the surface of the skin, purple-red, the pressure does not fade, can be fused into a piece, or herpes-like, urticaria-like or erythema multiforme, and can be accompanied Neuropathic edema.
In severe cases, ulcers and necrosis can occur. Purpura is more common in the extremities and buttocks of the extremities. The lower extremities and the joints such as the ankles and knees are more obvious. They appear symmetrically in batches and are prone to repeated attacks.
Joint disease
Most of the joint symptoms in patients with purpuric nephritis are characterized by migratory multiple joint pain. Commonly affected joints are knees, ankles and hands. Symptoms subsided within a few days, leaving no deformation of the joints. Some children have joint swelling and pain, and most involve large joints, such as knees, ankles, wrists, elbows, etc., small joints are not tired. Can be single, multiple or migratory. The joints are swollen, painful, and the pain is aggravated during the activity. The local is often accompanied by a slight heat, and the heavy one has a burning sensation. There is no sequelae after the joint symptoms have subsided.
Urinary system
Most children with purpuric nephritis show a small amount of protein in the urine and red blood cells under the microscope. Sometimes there is a cast, and there is also gross hematuria. The general prognosis is good, even after rapid progressive nephritis, the development of acute renal failure, poor prognosis. Some children have a large amount of proteinuria, hematuria, edema, hypertension, hypoproteinemia and hypercholesterolemia are nephrotic syndrome.
Gastrointestinal
Gastrointestinal manifestations of patients with purpuric nephritis are most commonly abdominal pain, mainly umbilical and lower abdomen, paroxysmal colic. May be accompanied by nausea and vomiting and bloody stools, occasionally vomiting blood. Children with purpuric nephritis can sometimes have intussusception, intestinal obstruction and intestinal perforation.
hypertension
Hypertension caused by purpuric nephritis accounts for about 20% to 40% of patients with hypertension, and blood pressure is generally mild to moderately elevated. Hypertension encephalopathy can occur in patients with some purpuric nephritis. Hypertension is often found at the same time as urinary abnormalities, but most patients with purpuric nephritis recover faster.
Examine
Examination of purpuric nephritis
(A) urinalysis must have varying degrees of hematuria, proteinuria and cast.
(B) platelet count, clotting time, prothrombin time are in the normal range; early eosinophils increased.
(3) Immunological examination: serum IgA can be increased but not specific; serum C3 and CH50 are mostly normal; blood circulation immune complexes are increased during active period.
(D) Severe cases may have a decrease in Ccr and blood urea nitrogen, creatinine; patients with nephrotic syndrome may have decreased serum albumin and elevated cholesterol.
(5) Renal puncture can determine the pathological type diagnosis of this disease and differential diagnosis with IgA nephropathy.
Diagnosis
Diagnosis and diagnosis of purpuric nephritis
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
When purpuric nephritis rash has subsided, it needs to be differentiated from acute nephritis; if accompanied by pulmonary hemorrhage, hemoptysis should be differentiated from Goodpasture syndrome; clinically, it should be differentiated from lupus nephritis and primary systemic vasculitis.
