Hemorrhagic vasculitis
Hemorrhagic vasculitis is a serious autoimmune disease characterized by damage to small vessels, as well as joints, skin and the renal apparatus.
reasons
Hemorrhagic vasculitis is a disease of rheumatic origin, therefore, the main causes are infectious agents – viral infections (influenza virus, herpes, acute respiratory infections), bacterial infections (streptococcus, mycoplasma, tuberculosis pathogens) and parasitic infections (trichomoniasis, worm infestations)
Other reasons may be – drug or food allergies, an inadequate reaction to the vaccination of the child, hypothermia or overheating of the child. We should also not forget about the genetic predisposition.
PATHOGENESIS
The main mechanism of hemorrhagic vasculitis development lies in the formation of immune complexes alien to the body. The formed complexes circulate in the blood, attaching to the inner walls of small blood vessels – arterioles and venules, thereby causing damage to the wall. Violation of the integrity of microcirculatory blood vessels leads to the development of the inflammatory process in aseptic conditions.
classification
There are several types (forms) of the clinical course of vasculitis:
Rheumatoid
Simple
Lightning Fast
Abdominal
According to the severity , there are also three types:
Mild severity – joint pain, slight rash – the general condition of patients is satisfactory
Moderate severity – abundant rashes, joint pain, joint changes (inflammatory reaction – arthritis), small amount of blood in the urine, periodic abdominal pain
Severe degree – massive subcutaneous hemorrhages, angioedema, a large amount of blood in the urine, areas of necrosis on the skin
COMPLICATIONS
Gastrointestinal bleeding
Acute renal failure
Hemorrhagic stroke
Renal syndrome
symptoms
The clinical picture of hemorrhagic vasculitis can be divided into specific syndromes.
Skin syndrome is the most common in the frequency of all manifestations of the disease. As a rule, skin rashes develop at the very beginning of the disease and are characterized by the appearance of hemorrhagic elements on the skin. The affected areas are small, but tend to increase, as well as merge. The rash is more often symmetrical in nature. Favorite localization – buttocks, thighs, shins, projection of large joints.
Articular syndrome is the second most common, reaching 70% of all clinical cases. With mild degrees of vasculitis, joint lesions have a short–term and reversible character – minor joint pain. With more serious lesions, pain can persist for a long time, and arthritis develops with limited joint functions. Large joints are most often affected.
Renal syndrome – manifests itself in 30% of cases and is characterized by the development of acute glomerulonephritis – micro and macrohematuria, urine the color of “meat slops”, in severe cases there are signs of renal failure.
Abdominal syndrome – can sometimes manifest together with joint and skin syndrome. It manifests itself in the form of abdominal pain of varying intensity. In severe cases, an attack of intestinal colic develops.
diagnostics
Consultation and examination by a rheumatologist
Clinical blood test
Urine analysis
Biochemical blood analysis
Ultrasound of the kidneys
Zimnitsky ‘s test
Skin biopsy
treatment
During the acute period of the disease, all patients must observe strict bed rest. In case of joint syndrome, it is recommended to limit joint mobility, apply a cold compress to the area of inflammation.
Drug treatment involves the use of heparin. Some specialists also prescribe prednisone therapy, however, the effectiveness of this drug is very doubtful.
Hemorrhagic syndrome is stopped by nonsteroidal anti–inflammatory drugs – Ibuprofen, Indomethacin. In some cases, hemocorrection procedures are required – plasmapheresis, immunosorption or hemosorption.
