Henoch Schonlein purpura nephritis in children

Henoch Schonlein purpura nephritis in children

Although HSP nephropathy and IgA nephropathy are similar in immune pathogenesis, there is a significant difference in clinical manifestations, IgA nephropathy is lack of HSP nephritis, renal manifestations of HSP nephritis

During the course of the disease, the clinical manifestations are different, the course of disease is shorter, and the degree of renal injury depends on the number of glomerular crescent. IgA nephropathy is chronic

Persistent development, easy to develop renal insufficiency, crescent formation is not obvious and segmental renal

nephropathy

nephropathy

Clinical manifestations: 1 renal manifestations of allergic purpura is mainly caused by the skin, gastrointestinal joints and other symptoms and signs.

(1) skin rash: symmetrical distribution in the lower limb extension, symmetrical, serious can affect the buttocks and lower abdomen elbow. Rash was slightly higher than the fresh red

Pimian, accompanied by itching and wheal, and repeatedly appear in bulk.

(2) joint: 1/2 ~ 2/3 patients with joint pain, knee joint and ankle joint to see more, activities can be limited, general a few days can be restored.

(3) 1/3 patients had gastrointestinal symptoms: paroxysmal abdominal cramps umbilicus, accompanied by vomiting, melena, hematemesis and other inpidual can appear intestinal obstruction, intestinal

Perforation and intussusception.

(4) other: such as epistaxis, hemoptysis, myocarditis, a small number of patients with headache, convulsions.

2 renal manifestations were hematuria and proteinuria.

(1) hematuria: about half of the patients had microscopic hematuria.

(2) proteinuria: varying degrees.

(3) edema: generally mild to moderate, non sag, with a large number of proteinuria can be depressed edema.

(4) hypertension.

3 other manifestations of Henoch Schonlein purpura nephritis can affect the central nervous system, cardiovascular system and pleural exocrine glands, and corresponding symptoms

.

Complication:

I see the intussusception, intestinal obstruction, intestinal perforation or necrosis; I met nerve paralysis, neuritis, transient hemiplegia; pulmonary hemorrhage, subarachnoid hemorrhage

Blood; hypertension, myocarditis, etc..

Diagnosis:

The diagnosis of Henoch Schonlein purpura nephritis is based on hemorrhagic rash and renal damage. A typical rash is helpful for the diagnosis of this disease

When the symptoms of skin rash have subsided, should be carefully examined the history (including gastrointestinal symptoms) and the appearance of rash on the typical symptoms of kidney, such as edema, high

Blood pressure, proteinuria, proteinuria, nephrotic syndrome and renal insufficiency, the diagnosis is easy; for minor changes in urine, urine protein in general qualitative (+)

And more than 5 /Hp, or from 2 to 3 /Hp, were used as diagnostic criteria. In the acute phase, the capillary fragility test was positive, but the platelet count and function test

It has some reference value for the diagnosis of this disease. Renal biopsy is helpful for the diagnosis of the disease and helps to understand the extent of the disease and evaluate the prognosis. skin

Biopsy is helpful for the identification of nephritis outside IgA nephropathy. ?

Differential diagnosis:

Due to the characteristics of Henoch Schonlein purpura nephritis in the acute stage of hemorrhagic rash, abdominal pain, intestinal bleeding, arthritis and nephritis, it is not difficult to diagnose

Broken. When the clinical manifestations are not typical, it should be differentiated from acute glomerulonephritis, IgA nephropathy, lupus nephritis and acute interstitial nephritis.

 

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