Purpura
Introduction
Purple introduction Purpura is a general term for color changes after skin and mucous membrane bleeding. The clinical manifestations are bleeding points, purpura and ecchymoses, which are generally not higher than the skin surface. They can only be slightly bulged when allergic purpura is present. They begin to be purple-red, the pressure does not fade, and then gradually becomes lighter, and becomes yellow after two weeks and subsides. Purpura is the most common clinical manifestation of bleeding disorders. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: anemia
Cause
Causes of purpura
Bacterial infection (20%):
Infected bacteria (the most common upper respiratory tract infection caused by -hemolytic streptococcus, in addition to Staphylococcus aureus, pneumococcus, Mycobacterium tuberculosis), viruses (rubella, varicella, measles, flu) and intestinal parasites.
Drug factors (15%):
Drug antibiotics (cyan, chain, red, chloramphenicol), sulfonamides, isoniazid, antipyretic analgesics (salicylic acid, phenylbutazone, quinine, etc.).
Heterologous protein rejection (20%):
Food, fish, shrimp, crab, egg, milk and other food heterosexual proteins.
Other factors (15%):
Such as cold, pollen, insect bites, vaccination, etc.
The above factors cause an antigen-antibody complex reaction, which deposits on the blood vessel wall or the glomerular basement membrane, activates complement, releases allergens, etc., damages capillaries, arterioles, causes extensive capillary vasculitis, and even appears Necrotizing arteriitis causes increased permeability and fragility of the blood vessel wall, resulting in hemorrhage and edema of the subcutaneous tissue, mucosa and internal organs. Similar changes can be made to the gastrointestinal tract and joints. Most of the renal lesions are focal mild nephritis. In severe cases, there may be glomerular capillary necrosis or total renal involvement. Some scholars believe that this disease is an immediate allergic reaction, a large amount of IgE is adsorbed on mast cells, and the bioactive substances released by the latter cause the above damage.
Prevention
Purpura prevention
1. Pay attention to rest, avoid fatigue, avoid mood swings and mental stimulation, and prevent insect bites. Remove possible allergens.
2, pay attention to keep warm and prevent colds. Control and prevent infections, use sensitive antibiotics when there are clear infections or infections, but avoid prophylactic antibiotics blindly.
4, pay attention to diet, because allergic purpura is caused by allergens, should be fasting raw onions, raw garlic, pepper, alcohol and other irritating food; meat, seafood, should avoid contact with allergens such as pollen.
5, in order to prevent recurrence, patients should adhere to a course of treatment after curing.
Complication
Purpura complications Complications anemia
anemia.
Symptom
Symptoms of purpura Common symptoms Skin ecchymosis serum enzymes change skin defects
Spontaneous mild skin imperfections or ecchymoses, mainly in the lower limbs, can occur in the upper limbs, but rarely occur in the trunk, no predisposing factors. Freckles or sputum are not the same size, uneven distribution, no higher than the surface, the pressure does not fade and does not hurt. There may be slight pain in the local area before the appearance of ecchymosis. Often, when the clothes are dressed in the morning of the next morning, the skin of the legs is consciously painful, and ecchymoses are found during the examination. Without treatment, the ecchymoses can resolve on their own, leaving a yellow-yellow pigmentation plaque that gradually disappears later. The purpura often recurs and is aggravated during the menstrual period. Patients generally have no internal organs and other parts of the bleeding. Mucosal bleeding is rare, sometimes a small amount of bleeding gums, increased menstrual flow, prolonged menstruation. The amount of bleeding during tooth extraction, surgery, trauma, and childbirth can be slightly more, but it will not cause severe bleeding.
Examine
Purpura examination
(1) The beam arm test is positive or negative, but the routine examination of hemostasis function is normal.
(2) In a small number of patients, platelets are abnormal in ADP and adrenaline-induced aggregation, and the adhesion rate to the bead column is reduced.
(3) It is always healthy. Most of the lower extremities spontaneously appear sputum or ecchymosis, which can resolve on their own. No family history.
(3) It can exclude purpura caused by other causes.
Diagnosis
Diarrhea diagnosis
Diagnostic criteria
(1) It is always healthy. Most of the lower extremities spontaneously appear sputum or ecchymosis, which can resolve on their own. No family history.
(2) The beam arm test is positive or negative, but the routine examination of hemostasis function is generally normal.
(3) It can exclude purpura caused by other causes.
Differential diagnosis
1 Aspirin-like defect: It is an autosomal dominant hereditary disease with dysfunction of platelet release. Patients were particularly sensitive to aspirin; platelet counts were normal; PF-3 was not effective. Clinically, the distribution of skin sputum is uneven, mucosal bleeding is obvious, and bleeding is more serious during trauma or surgery.
2 light vascular pseudohemophilia: mucosal or visceral bleeding. Some patients have prolonged bleeding time; aspirin tolerance test is positive; VIII: C is decreased, VIIIR: Ag is decreased significantly; platelet adhesion rate can be decreased; platelet is less attenuated by ristocetin.
