toxic purpura
Introduction
Introduction to toxic purpura Most of the disease is caused by drugs, so it can also be called drug purpura. Toxic purpura refers to the toxic manifestation of purpuric lesions caused by a certain substance entering the body through various routes. Many chemicals and drugs enter the body due to their toxic effects causing thrombocytopenia, or direct inhibition of bone marrow or due to capillary damage, or due to coagulation defects. The above lesions may also be caused by the allergic mechanism. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: hemolytic anemia
Cause
Toxic purpura
Chemical and drug damage (25%):
Many chemicals and drugs enter the body, causing thrombocytopenia due to their toxic effects, or direct inhibition of bone marrow, or due to capillary damage, or due to coagulation defects, may also cause the above-mentioned lesions due to allergic mechanisms.
Thrombocytopenia (20%):
It is a common cause of toxic purpura, and its mode of action is:
(1) Substances with extensive inhibition of bone marrow: benzene, inorganic arsenic, gold preparations, cytotoxic drugs (alkylating agents, metabolic antagonists, vinblastine, etc.), chloramphenicol, streptomycin, sulfisoxazole, Sulfamethoxine, isoniazid, chlorpromazine, diazepam, chlordiazepine (limonine), phenytoin, methadone, trimethyldione, mipalin (Api), phenylbutazone, etc. With anemia or leukopenia.
(2) Drugs that selectively inhibit the action of bone marrow megakaryocytes: erythromycin, penicillin, tetracycline, sulfadiazine, chlorpropamide, tolbutamide, indomethacin (indomethacin), aminopyrine (pila) Midong), aspirin, codeine, colchicine, phenobarbital, barbital, penicillin, digitalis, hydrochlorothiazide diuretics, reserpine, hydralazine (hydralazine), amphetamine, acetyl Zolazole, estrogen and ethanol.
(3) Drugs that reduce thrombocytopenia through immune mechanisms: penicillin, streptomycin, neomycin, cephalosporins, sulfonamides, thiouracil, quinidine, quinine, antipyrine, aspirin, Too loose, sodium salicylate, arsenic, gold salt, tincture, isoniazid, carbopol, chloroquine, pentobarbital, phenobarbital, digitalis, chlorpropamide, acetazolamide, chlorine Thiazines and the like.
Platelet dysfunction (15%):
Drugs that cause platelet dysfunction but are normal in number are: dextran and aspirin, which can reduce platelet adhesion and cohesiveness, resulting in platelet disease, other anti-platelet aggregation drugs are beneficial to flattening, phenformin (hypoglycemic), phenylbutazone, Antihistamines, ethyloestranol and sulphinpyrazone.
Drug interference with the synthesis of coagulation factors (10%):
Dicoumarin and related compounds can interfere with the synthesis of coagulation factors.
Capillary damage (15%):
Causes capillary damage and produces purpura with or without thrombocytopenia. These substances are: carbromal, chloramphenicol, chlorothiazide (clones), chlorpromazine, diethylstilbestrol, gold salts, Isoniazid, on salicylic acid, phenobarbital, piperazine, quinidine, quinine, reserpine, reserpine, snake venom, sodium salicylate, thiourea, toluene Butyl urea (methylglycine), nitroglycerin, phenacetin and the like.
Prevention
Toxic purpura prevention
Remove pathogenic factors, avoid re-use of pathogenic drugs, and no longer be exposed to harmful substances.
Keep fit: A moderate amount of physical activity promotes cell metabolism. Keep enough sleep, let the body have enough time to make new cells, absorb nutrients, carry out metabolism, and regulate body temperature, blood pressure and hormone secretion. Pay attention to the balanced nutrition of the diet so that the body can get the vitamins and minerals needed to improve immunity. Always relax and be happy. These measures help to fight allergies.
Complication
Toxic purpura complications Complications hemolytic anemia
May be associated with hemolytic anemia and a variety of neurological and psychiatric symptoms.
Symptom
Symptoms of toxic purpura Common symptoms Itching skin
Due to accidental contact with industrial production or contact due to treatment needs, bleeding symptoms during inhalation of poison or medication, the size and severity of purpura can vary from a few spots to a wide range of ecchymoses, and can also affect important organs.
Drugs cause immune thrombocytopenic purpura, its incidence is often rapid and serious, damage to the initial sputum, ecchymosis, or large bullous, hemorrhagic necrosis and oral mucosal hemorrhagic bullae, 6-12h after the gastrointestinal Road and urinary tract bleeding.
Diethyl bromide acetylurea (ie, bromine urea) is one of the few drugs that cause special types of purpura. The damage is cyanosis, which is caused by extensive capillary leakage with erythema. It is clinically similar to pruritic purpura and progressive pigmentation. Purpuric dermatosis (Schamberg disease).
Examine
Examination of toxic purpura
Laboratory tests, including various thrombocytopenic purpura, can also be used to determine antibodies caused by drugs, including coagulation, complement fixation, platelet third factor release, and clot retraction inhibition assays.
Diagnosis
Diagnosis and identification of toxic purpura
Careful examination of medical history, exclusion of other purpura, can generally establish a diagnosis. Clinically, it should be differentiated from other purpuric lesions.
