Purpura Nephritis

Shijiazhuang Kidney Disease hospital

description
Rheumatoid purpura or Henoch-Schönlein purpura is a leukocytoclastic vasculitis affecting small vessels (capillaries whose renal glomerulus, venules and arterioles) which are deposited immune deposits of immunoglobulin A (IgA). It is characterized by the association of skin, joint and gastrointestinal signs that may occur in successive crops. Kidney disease is sometimes associated with these signs. The long-term prognosis depends on the severity of renal disease. There is currently no specific treatment. The nephropathy IgA deposits observed in children is nephropathy rheumatoid purpura.
causes
Regarding its pathophysiology, little progress has been made. The abnormal response of an immature immune system to an external antigenic aggression is the most frequently advanced hypothesis [2, 3]. It is based, firstly, on the existence, in some of these patients immune system abnormalities. There is, in effect, in a variable number of cases, an increase in serum IgA levels, unbalanced in favor of the subclasses IgA1, circulating immune complexes consisting of IgA, the glycosylation defects IgA and increasing the number of circulating B-cells bearing membrane IgA and capable of producing in vitro excess of IgA. On the other hand, the disease is often preceded by an infection of the respiratory or ENT sphere (Streptococcus, adenovirus, parvovirus, Mycoplasma pneumoniae ...) or drug, toxic and food intake, especially in children . It has also been associated with other viral infections such as EBV, CMV, HIV.
symptoms
The HSP diagnosis is made on clinical when associate with cutaneous purpura joint manifestations, Digestive and Kidney. The HSP is a systemic vasculitis of small vessels. The association of purpura and arthralgia. The skin and joint disease, abdominal pain colic type sanglante.l'atteinte diarrhea and kidney, while completing the description of this pathology. It has recently been suggested that the HSP was the systemic form of the primary glomerulonephritis IgA deposits characterized.
diagnosis
The HSP diagnosis is made on clinical when associate with cutaneous purpura joint manifestations, digestive and rénales.Le rheumatoid purpura is a systemic vasculitis of small vessels. The association of purpura and arthralgia. The skin and joint disease, abdominal pain colic type sanglante.l'atteinte diarrhea and kidney, while completing the description of this pathology. It has recently been suggested that the HSP was the systemic form of the primary glomerulonephritis IgA deposits characterized.
treatments
Corticosteroids are effective in decreasing abdominal and joint pain, as usual analgesic. They have not proven effective in preventing gastrointestinal complications. Plasma exchange, alone or in combination with steroids and / or immunosuppressants have been proposed in the most severe forms, as well as intravenous gammaglobulin.
Characteristic treatments
Micro-Chinese Medicine Osmotherapy
immunotherapy
immunotherapy
complications
Joint manifestations are present in two thirds of cases and result in arthralgias primarily affecting the ankles and knees.
Digestive manifestations are frequent, variable according to the series. This is type of colic pain, moderate but can be severe, so leading to the laparotomy. They may be associated with occult gastrointestinal bleeding (blood in the stool in the strip) but sometimes very serious, life-threatening.

Other events are much rarer. As part of the neurological manifestations, there may be headache, convulsions, paresis, or even coma. More rarely are disclosed orchi-épidydimites (most often in young boys), urethritis, pancreatitis, parotitis, myositis, episcleritis, pulmonary hemorrhage and myocarditis.