Vasculitis is a group of pathological conditions. They are united by one common characteristic feature - an inflammatory process in the walls of blood vessels, leading to their damage and gradual destruction. Both large veins and arteries, and small capillaries can be at risk. Progressing, the disease affects adjacent tissues and internal organs, which disrupts their normal functioning and upsets the work of the whole organism.
Pathologies affect both men and women of all ages. Especially dangerous are those cases when vasculitis occurs in a child. A young unformed organism is not able to cope with the disease on its own. Seeking medical attention in a timely manner will help avoid complications.
Variations of vasculitis
Vasculitis is divided according to a number of characteristics: the type and degree of damage to blood vessels (arteries, veins, capillaries), the localization of the focus, its size, etc. This makes their classification rather complicated, in addition,it is reviewed frequently. However, two large groups of vasculitis should be distinguished:
- systemic - lead to damage to tissues and organs due to disruption of their blood supply;
- skin - appear as specific rashes on the skin, rarely leading to complications.
Also, for the main reason for their occurrence, vasculitis is divided into the following groups:
- primary - arising as an independent disease due to failure of immune mechanisms;
- secondary - arising against the background of other diseases (infectious, viral, parasitic, etc.).
Vasculitis in a child and an adult is subject to a single classification.
What is the danger of vasculitis in children?
If a child develops vasculitis, then the risk of its generalized course increases, that is, spread throughout the body. An unformed children's body cannot cope with the pathological process itself, and the disease progresses rapidly. Therefore, the onset of the disease can proceed in an acute form. And after recovery, the likelihood of relapse increases.
Fever, deterioration in general condition, loss of appetite, a characteristic rash that causes discomfort and itching are signs by which vasculitis in children can be recognized (photo is presented below).
The situation is complicated by the fact that the child begins to comb problem areas, which injures the skin, provokes the formation of scar tissue. Through wounds, an infection penetrates into the blood, this further worsens the condition andslows down the healing process.
If there are complications, any vasculitis can flow into other more severe forms. Then not only skin vessels are affected, but also large and small arteries and veins of other areas of the body and internal organs. Muscles and joints that do not receive sufficient nutrition and blood supply gradually atrophy and lose their mobility. Such dangers entail vasculitis in a child. Treatment and qualified assistance must be timely.
Hemorrhagic vasculitis in children
Hemorrhagic vasculitis is also known as Henoch-Schonlein disease. A fairly common disease in children from 4 to 7 years old, but can occur in infants. The reasons for the appearance are the transfer of infectious diseases (viral, bacterial), parasitic invasions, various vaccinations, food allergies.
The first evidence of the manifestation of the disease is a hemorrhagic skin rash of varying degrees of intensity. Most often it is localized on the lower extremities, near the joints, folds. Very rarely, rashes appear on other parts of the body - palms, feet, neck, face. At this stage, the lesion spreads to small vessels of the skin. This is the main sign by which hemorrhagic vasculitis is determined in children.
Symptoms characteristic of the disease may appear in parallel with the skin rash or at its later stages. This is a lesion of the joints, manifested in the form of pain, inflammation, swelling. It is possible to involve the digestive organs in the pathological process, which is accompanied byheaviness in the abdomen, colic, nausea, vomiting.
At the 1st or 2nd year of life, the development of a fulminant form is possible, which greatly complicates hemorrhagic vasculitis in children. The causes of occurrence are the transfer of so-called childhood infections - scarlet fever, chickenpox, rubella, etc. The course of such a disease is always acute, characterized by excessive manifestation of all symptoms and can be dangerous for an unformed child's body.
Clinical Forms
For convenience in clinical practice, hemorrhagic vasculitis is usually divided into the following forms:
- A simple shape. Known as cutaneous purpura. It manifests itself in the form of a reddish rash - this is the most basic diagnostic sign and symptom. Most often affects the lower extremities, rarely rises higher.
- Skin-articular purpura. A more severe form of the disease. In addition to skin rashes, joint damage occurs. This is accompanied by pain and swelling. The knee joints are especially affected, less often the elbow and wrist joints.
- Abdominal purpura (syndrome). Accompanied by pain and pain in the abdomen, vomiting, nausea. In the presence of only this symptom, it is extremely difficult to diagnose hemorrhagic vasculitis in children. The causes of the disease are damage to the abdominal organs, namely the gastrointestinal tract.
- Renal syndrome. Often develops against the background of other signs of the disease.
- Mixed form. Can combine 3 attributes at the same time or all.
- Rare forms. Expressed in the defeat of the lungs, nervous system, genital organs. Meet inisolated cases.
Causes of occurrence
Hemorrhagic vasculitis is classified as an immunocomplex disease. Immune complexes are involved in its occurrence and course - antigen-antibody compounds (AG - AT) circulating in the blood.
Their appearance is considered a response to the penetration of foreign or pathogenic agents into the body - cell debris, toxins, bacteria, microscopic fungi, viruses, protozoa (parasites). That is why hemorrhagic vasculitis usually develops several weeks after suffering from infectious diseases or vaccination.
Usually, AT-AG complexes are destroyed by special blood cells - phagocytes. But sometimes they can accumulate in the bloodstream, “settle” in adjacent tissues and organs, and cause inflammation. In addition to the occurrence of AG - AT complexes, the permeability of the walls of blood vessels increases, and the complement system - proteins involved in the immune response - is activated. These parameters are used for laboratory diagnostics.
Diagnosis of disease
Vasculitis in a child is diagnosed by the following signs:
- The presence of a skin rash of purple and red shades. Spots of small diameter, convex shape. Can occur on any part of the body, but most often on the lower extremities.
- Abdominal (from lat. abdomen - belly) pain. May be intermittent, aggravated each time after eating.
- Biopsy (examination of a tissue fragment) of the walls of venules or arterioles demonstratesincreased granulocyte count.
Laboratory findings are not diagnostic in this case. However, attention is paid to an increase in the amount of type A immunoglobulins in the blood serum. Also important indicators can be a high titer of AntiStreptoLysin-O (ASL-O) and erythrocyte sedimentation rate (ESR), which are used to diagnose vasculitis in children.
Forecasts may be favorable. In some cases, all symptoms disappear after about 30 days after the acute onset of the disease. However, there is a risk of kidney failure, gastrointestinal complications, or central nervous system damage.
Hemorrhagic vasculitis in children: treatment
Treatment of hemorrhagic vasculitis begins only after the final diagnosis and causes of the disease by a specialist. Therapy will depend on the phase of the disease and the degree of its development.
In any case, limit physical activity. This is especially important during the acute course of the disease. Bed rest is prescribed until the stable disappearance of the skin rash. Its average duration is approximately 3-4 weeks. Violation of this condition can provoke repeated hemorrhagic rashes. In the event of complications and the acute course of the disease, bed rest is extended.
Be sure to prescribe a diet with a strict exclusion from the diet of allergenic and potentially allergenic foods. If the disease proceeds in the form of an abdominal syndrome, then appointdiet number 1. If the situation is complicated by severe nephritis - diet No. 7 (exclude s alt, meat, cottage cheese). Such nutrition will reduce the unpleasant manifestations that lead to hemorrhagic vasculitis in children.
Treatment, regardless of the form of the disease, includes taking antiplatelet agents - drugs that reduce blood clots, as well as fibrinolysis activators - substances involved in the "dissolution" of blood clots. The composition and quantity of medicines, their dose and duration of administration are approved by the attending physician.
Since the onset of the disease is associated with the launch of immune mechanisms, treatment consists in removing AG-AT complexes from the body. In severe cases of the disease and the absence of contraindications, mechanical blood purification is carried out - plasmapheresis. This procedure will remove from the blood not only immune complexes, but also pathogenic bacteria, microscopic fungi, toxins.
Allergic vasculitis in children
The cause of this disease is an allergic reaction. As a rule, this is an immune response to medicines, food, or an infection in the body. The result is inflammation and vascular damage, mainly in the skin. Most often it develops in children under 15 years of age after the transfer of infectious diseases or a course of drug treatment. Sometimes the cause of allergic vasculitis in children may not be clear. Then a thorough study of the medical history is necessary.
The main symptom is an extensive rash that causes itching. It looks like spots and/orconvex bumps of purple or red-lilac color on large areas of the skin. They mainly appear on the legs, thighs, buttocks. Perhaps the formation of blisters and ulcers, scarring of damaged vessels. Allergic vasculitis usually resolves on its own within a few weeks. However, complications are possible in the form of damage to internal organs due to a violation of their blood supply.
Varieties and forms
Depending on the diameter of the affected vessels, there are:
- superficial (dermal) allergic vasculitis - affects the capillaries, arterioles and venules lying in the skin;
- deep or dermo-hypodermal - occurs when medium-sized arteries and veins are involved in the pathological process.
Depending on the stage of development of the skin rash, there are several forms of the disease:
- papular - rashes are convex, palpable, pigmented;
- vesicular - bubbles (vesicles) with liquid contents are formed;
- pustular - pus-filled cavities appear;
- ulcerative - necrotic ulcers appear at the site of pustules;
- scarring - accompanied by scarring of damaged skin.
Treatment of allergic vasculitis
It aims to reduce inflammation through medication. The complex therapy also includes taking drugs that reduce the formation of blood clots (antiplatelet agents), increase vascular tone, and antihistamines to reduce allergic manifestations. If the disease is recurrent in nature, you can not take medicines,used earlier, it is possible that the body has developed resistance to them.
To eliminate the influence of food allergic agents, enterosorbents are prescribed. These drugs bind and remove toxins from the intestines, preventing them from entering the bloodstream. In addition, a strict diet is required with the exclusion of foods that can trigger an immune response. These are mandatory measures when vasculitis is diagnosed in children.
The causes of illness can be varied. Sometimes, if the need arises, medicines and drugs that can lead to an allergic reaction are excluded. The duration of therapy depends on the nature of the course of the disease (undulating or recurrent).
What is important for parents to know?
Parents need to be very careful about any rashes on the child's skin. Even to those that seem insignificant at first glance. It is important for parents to understand that vasculitis in a child can occur in waves: periods of remission are replaced by relapses. Moreover, the symptoms of a newly appeared disease may differ from those that were previously. Timely seeking medical help will help to avoid unpleasant consequences.
You should not self-prescribe treatment for a child if vasculitis has been suspected. In children, the symptoms of the disease can be ambiguous. Diagnosis and treatment should be carried out by a qualified specialist. In particular, one should not show independence when choosing immunostimulating and immunomodulatory drugs. After all, the main reasonthe appearance of any form of vasculitis - a violation of the mechanisms of the protective functions of the body.
To prevent the recurrence of the disease in a child, following simple measures will help:
- limiting stress factors;
- Providing a he althy diet, an active lifestyle;
- presence of light physical activity;
- strengthening immunity.
It is important to understand that illnesses suffered by a child at an early age can adversely affect his physical and mental development.
