Schonlein's disease - Henoch, or hemorrhagic vasculitis, is an inflammatory disease that affects not only the human vascular system, but also the skin, joints, gastrointestinal tract, and renal glomeruli. This pathology is equally developed among both children and adults. Diagnosis is based on various research methods, and treatment of vasculitis involves the use of anticoagulants.
What is this
Vasculitis is one of the most common hemorrhagic diseases. In most cases, this pathology is equated with an allergic type of superficial nature, which affects small arteries and veins, as well as capillaries. Basically, hemorrhagic vasculitis is diagnosed in children whose age category is within 4-13 years. The most susceptible to the inflammatory process are children aged 6-13.
The disease proceeds in stages andaccompanied by severe symptoms. It occurs as a result of various provoking factors that can only be established after a thorough examination. As for the treatment of vasculitis on the legs and other parts of the body, it is long-term and is selected for each patient individually. Do not engage in self-therapy, as this can lead to irreversible consequences.
Classification
In modern medicine, there is a certain classification of this disease, which is recommended to follow when making a diagnosis. So:
- Clinical course: acute phase (the onset of the disease or a period of exacerbation) and the subsidence phase (improvement in general condition).
- Forms according to symptoms: simple, articular, abdominal, fulminant.
- By severity: mild, moderate, severe. Each of the degrees is represented by certain symptoms.
Also, according to the nature of the course, the pathology is: acute (up to two months), protracted (up to 6 months), chronic.
Reason for development
In order for the treatment of vasculitis to be effective, it is worth correctly identifying the provoking factor. The underlying cause of modern medicine has not yet been established, but there are opinions that pathology may develop as a result of:
- Past respiratory illnesses, especially after a sore throat or scarlet fever.
- An allergic reaction of the body to food or medicines.
- Poor-quality vaccination.
- Hypothermia.
- Insect bite.
Immune disorders can also provoke the development of vasculitis.
Symptomatics
All symptoms of hemorrhagic vasculitis are combined into groups of syndromes. These include the following:
- Skin syndrome. The patient has small hemorrhages that rise above the skin. They can be observed in the joints, hands, feet, thighs, buttocks, face, or throughout the body. After the patient gets rid of the hemorrhage, pronounced pigmentation remains in its place. It is also worth noting that with this type of pathology, the patient does not have blood flow from the nose and mouth.
- Articular syndrome. It manifests itself in the form of pain and swelling in the joints, especially on the legs. In this case, discomfort may increase during the period of hemorrhage under the skin. The skin over the joints changes color. This condition can be observed within 5-7 days. It should be noted that there is no permanent change in the shape of the joints with a violation of their functionality.
- Abdominal syndrome. May be accompanied by an outpouring of blood into the intestines and peritoneum. In this case, the patient will complain of pain of an intense, paroxysmal nature, which are noted in the navel. The skin of the patient becomes pale, the face is emaciated, the eyes sink, there is dryness of the tongue. The patient in this state is restless, can only lie on his side. Simultaneously with the pain syndrome, vomiting and diarrhea with bloody impurities appear. Discomfort passesalone or after the first days of vasculitis treatment.
- Renal syndrome. In this situation, damage to the small vessels of the kidneys is noted. In this case, the patient has blood in the urine, high blood pressure and swelling.
If the patient began to develop anemia against the background of vasculitis, then signs such as malaise, decreased performance, dizziness, fainting, tinnitus, tachycardia without good reason, stabbing pain in the chest. Treatment of vasculitis in adults is based on the elimination of symptoms and other problems.
Diagnosis
After the patient has turned to a specialist, he is examined, the course of the disease and complaints are analyzed. Then attention is paid to the quality of life. The doctor must find out if there are chronic diseases, hereditary pathologies, whether the patient suffers from bad habits, whether he is taking drugs, whether he has been vaccinated in the near future.
It is mandatory for the patient to be assigned such types of examinations as:
- Blood test. At the initial stage of vasculitis, the indicators remain unchanged. Then deviations such as an increase in the number of leukocytes and ESR, a decrease in erythrocytes and hemoglobin may occur.
- Urine and stool analysis. With the progression of the pathology, a bloody admixture will be noted in the biological material.
- Biochemistry of blood. The level of cholesterol, sugar, creatinine, urea, electrolytes is determined. This analysis helps to identify existing pathologies.
- Immunological and virological study.
Attention is drawn to the duration of bleeding in the patient, blood clotting. A pinch, tourniquet, cuff test can be performed. Also, do not exclude ultrasound examination of the abdominal organs, examination of the kidneys, biopsy of the skin, endoscopy, FEGDS, colonoscopy, bronchoscopy, laparoscopy, bone marrow examination, trephine biopsy.
Differential Diagnosis
Treatment of hemorrhagic vasculitis in adults will be effective only if not only diagnosis is carried out, but also attention is paid to differential research. The symptoms listed earlier occur not only with this disease, therefore, consultation of many highly specialized specialists is required. Vasculitis should be distinguished from such abnormalities and conditions as:
- Infectious-type endocarditis.
- Vasculitis of a systemic type.
- Diffuse connective tissue pathologies.
- Meningococcal disease
- Cryoglobulinemic vasculitis.
- Yersiniosis.
Vasculitis is also often confused with Crohn's disease.
Vasculitis treatment
Photo pathology presented above in the article. Treatment of the disease will depend on many factors. For example, from the phase, clinical form, severity of manifestations and nature of the course. Only a specialist can determine these data after a thorough and lengthy examination.
To a patient withthis type of vasculitis may be prescribed:
- Antiaggregants - Curantil and Trental. If the disease is severely neglected, then two drugs are prescribed at once. Analogues of these drugs can be used. The dose is selected individually. If there is no positive effect from therapy, then the dose of drugs is increased.
- Fibrinolysis activators. The dosage is selected taking into account individual susceptibility.
- Glucororticosteroids. They are prescribed only for severe pathology.
- Cytostatics. Prescribed to the patient with severe vasculitis, as well as kidney damage, severe skin syndrome.
- Antihistamines. In most cases, they are prescribed for the treatment of vasculitis in children who suffer from various types of allergic reactions.
- Enterosorbents.
- Membrane stabilizers.
Plasmopheresis may also be prescribed. It normalizes blood properties, eliminates spasms in blood vessels, improves microcirculation, increases the activity of immunological cells and the patient's susceptibility to drugs.
The duration of treatment for vasculitis will depend on the severity and clinical form. In a neglected case, therapy can be delayed for a year. If the patient has a chronic stage, then repeated courses are held every 3-6 months.
Complications
If you exclude the treatment of vasculitis on the legs, then this can lead to certain problems. With regard to outcome in children, mostcases it is favorable. If therapy was provided out of time, then the disease develops into a chronic form and is accompanied by skin and joint syndrome. Damage to the kidneys may also be noted, over time, the functionality of which is impaired. As for chronic renal failure, it is diagnosed in rare cases.
Prevention measures
Vasculitis prevention is mandatory. Experts recommend following these tips:
- Strengthening immunity.
- Timely detection and treatment of infectious diseases.
- Stop taking unnecessary medications.
- Don't get too cold.
- Rejection of excessive physical activity.
- Early diagnosis of vasculitis. Symptoms and treatment of this pathology are always interconnected.
- Exclusion of contact with substances and components that can provoke an allergic reaction of the body.
- If the disease is already progressing, then it is worth excluding vaccination as a preventive measure.
- Quit smoking and drinking alcohol.
If you follow these recommendations, the disease will not disturb and will not develop into a chronic stage.
Vasculitis in children
As mentioned earlier, this type of vasculitis is more common in children than in adults. In most cases, it is diagnosed in boys. It can occur in an acute, protracted or chronic phase.
In medicine, these forms of childhood vasculitis are distinguished:
- Simple.
- Rheumatoid.
- Lightning fast.
- Abdominal.
Provoke vasculitis in a child can be factors such as hypothermia, trauma, taking and intolerance to drugs, an allergic reaction of the body, and a poor-quality vaccination.
Pathology is also accompanied by severe syndromes:
- In most cases, there is a skin syndrome, may be supplemented by articular, which is rarely persistent.
- Also for children with this diagnosis, abdominal syndrome is also typical, which lasts for several days. Hemorrhagic vasculitis can provoke many diseases of the abdominal cavity.
- As for the vascular syndrome, it rarely occurs.
Diagnosis is carried out as in adult patients. Attention is also paid to the differential type of research.
Treatment of childhood vasculitis
Treatment of children with this pathology is carried out in a hospital. When improvement is noted, therapy continues at home. Bed rest for vasculitis is recommended for at least 23 days.
The therapy itself is complex, a strict diet is mandatory. Allergen foods are excluded from the diet. During the treatment of vasculitis on the legs (photo of the disease, see above) and other parts of the body, various drugs are used. Children are not allowed to prescribe sulfonamides, antibiotics, ascorbic acid and calcium supplements. The basis is heparin therapy. They can prescribe prednisonevascular preparations, antiaggregants, sorbents. If the disease progresses, then plasmapheresis is recommended.
If the treatment of hemorrhagic vasculitis in children is delayed, complications such as perforation, intussusception, bleeding in the gastrointestinal tract, peritonitis and acute anemia may occur.
