Hemorrhagic vasculitis is a disease in which affected mainly capillary vessels of the skin, joints, gastrointestinal tract and kidneys.
At the heart disease is increased production of immune complexes, increasing the permeability of vascular wall, activation of the complement system, damage to the capillary walls.
The disease can begin regardless of the age of the patient.However, experts note that children under three years of age the disease is found extremely redko.Statisticheski, often hemorrhagic vasculitis diagnosed in children aged four to twelve years.
Typically, hemorrhagic vasculitis in adults and children is revealed through 1- 4 weeks after SARS, sore throat, scarlet fever or other infectious disease.In some patients, the catalyst of the disease appears vaccination, drugs intolerance, food allergies, injury or hypothermia.
symptoms and signs of illness
In most children the disease begins with a characteristic skin rash.The latter are melkopyatnistye, sinyachkovye elements wit
The most common lesions are localized on the extensor surfaces of the extremities, in the area of the joints and on the buttocks.The rash on the face and body, feet and hands far less marked.The intensity of the eruption may be different - from single spots to multiple elements, which tend to merge.
At the expiring rash can watch the rest of pigmentation, which when frequent relapses causes skin peeling.Joint damage can be called the second feature of this disease.This symptom is observed in 2/3 patients.As a rule, it appears simultaneously with the rash in the initial stage of the disease, or in the later stages.
defeat of joints varies in a wide range: from short and unpleasant pain in the affected joint to a pronounced inflammation.Mostly hemorrhagic vasculitis affects large joints, especially the ankle and knee.
the course of the disease and edema observed changes in joint form, as well as his pain.Joint pain can be felt from a few hours to a couple days.This strain resistant joints with functional disorders in hemorrhagic vasculitis does not happen.
Pain in the abdomen is the third frequency to identify clinical symptom of hemorrhagic vasculitis.This can arise as a symptom in combination with other signs of illness, and before they occur.
However, some patients complain of moderate pain in the abdomen, is not accompanied by digestive disorders without causing much suffering.
Typically, these pains are themselves a couple of days.Other patients complain of pain paroxysmal character, appearing similar to intestinal colic, do not have the exact location.Such painful attacks may be repeated for several days.
Also, many patients reported fever, unstable stool, nausea and vomiting.In rare cases, against the background of the above clinical pathology observed episodes of stomach and intestinal bleeding.
disease for the disease are marked non-specific changes in laboratory parameters.In hemorrhagic vasculitis may increase the sedimentation rate and white blood cell count, as well as Dysproteinemia with increased alpha-2-globullinov.
Increased non-specific indicators are also observed for the categories that characterize the presence of inflammation.Immunological changes are expressed in the form of higher levels of immunoglobulin A, as well as increase the level of circulating immune complexes and cryoglobulins.
often noted and reduced levels of immunoglobulin G and complement activity.In severe cases observed hypercoagulable laboratory manifestations.
Hemorrhagic vasculitis and pregnancy
Like most autoimmune pathologies, for hemorrhagic vasculitis characterized by the development of secondary antiphospholipid syndrome (APS).The latter, in turn, can cause a number of further complications in pregnancy.
So, in APS may occur placental insufficiency, preeclampsia, intrauterine growth retardation and growth retardation, cardiac and placental abruption.
It is worth to clarify that the APS can also develop independently of the main flow of the disease, at any stage of pregnancy.Experts recommend to carry out a thorough investigation on the APS and other violations and put in the framework of such checks all the relevant tests.In identifying hemorrhagic vasculitis on the background of pregnancy, standard appointed receiving heparin and aspirin in low doses.
Effective treatments in adults
Depending on the condition of the patient and the particular phase of the disease, the treatment of this pathology conducted using various techniques.In all forms of the violation as a hemorrhagic vasculitis - treatment involves the use of antiplatelet agents.
In severe form of the disease, to enhance the effect of this technique may appoint two drugs with similar effects at the same time.
dosage of anticoagulants adjusted individually in each case.When choosing the correct dose of the specialists are guided by the positive dynamics of clinical symptoms of the existing, as well as to stabilize the laboratory parameters.
In the absence of the expected clinical and laboratory effect, the dose is gradually increased.For example, when to moderate disease course of treatment usually takes up to 28-30 days.Cancel also made preparations gradually.
Treatment of hemorrhagic vasculitis in children
In severe disease in children using transfusion therapy for 1-2 weeks during the acute period of the disease, in which the most pronounced clinical symptoms.In addition, in severe hemorrhagic vasculitis is assigned to conduct plasmapheresis.
This procedure is aimed at cleansing the blood of toxins, bacteria, antibodies, immune complexes, inflammatory substances and cryoglobulins.
Antihistamines are effective in children who have food, household or drug allergy history, exudative-catarrhal diathesis, allergic diseases, and others. Treatment with drugs of this group, as a rule, be conducted within 7-10 days.
Possible consequences of the disease
In general, the outcome of this disease in children is quite favorable.After the first manifestation of the disease indicated full recovery in 50% of patients.
also possible the transition from the acute illness in the long-term recurrent stage, in which the relapse rate varies from one-time displays in a couple of years before monthly.
According to experts, the observance of a certain diet at such a disease is necessary, as with any disease that affects the gastrointestinal tract.
Therefore, treatment of hemorrhagic vasculitis starts with the patient power of correction.