Effective treatment and diagnosis of hemorrhagic vasculitis

Hemorrhagic vasculitis is a disease in which the capillaries of the skin, joints, digestive tract and kidneys are mainly affected.

The pathology is based on increased production of immune complexes, increased vascular wall permeability, activation of the complement system, damage to the capillary walls.

This disease can begin regardless of the patient's age. However, experts note that in children under the age of three this disease is extremely rare. Statistically, hemorrhagic vasculitis most often occurs in children aged four to twelve.

As a rule, hemorrhagic vasculitis in adults and children is revealed through 1- 4 weeks after ARI, sore throat, scarlet fever or other infectious disease. In some patients, the catalyst for the development of the disease is vaccination, drug intolerance, food allergy, trauma or hypothermia.

Symptoms and signs of a disease

In most children, this disease begins with characteristic skin rashes. The latter are small-spotted, sinewy elements with a symmetrical arrangement, which do not disappear when pressed.

Most often, the rashes are localized on the extensor surfaces of the limbs, around the joints and on the buttocks. Rashes on the skin of the face and trunk, feet and palms are marked much less often. The intensity of rashes can be different - from single spots to multiple elements, which tend to merge.

With the extinction of the rash, the remaining pigmentation can be observed, which, with frequent relapses, causes skin peeling. The defeat of the joints can be called the second characteristic sign of the disease. This symptom is observed in 2/3 of the patients. As a rule, it appears simultaneously with the rash at the initial stage of the disease, or at a later date.

Joint damage varies in a wide range: from short-term unpleasant and painful sensations in the affected joint to a pronounced inflammation. Predominantly hemorrhagic vasculitis affects large joints, especially the ankles and knees.

The edema develops with the course of the disease and changes in the shape of the joint, as well as its soreness, are observed. Pain in the joints can be felt from a few hours to a couple of days. At the same time, the deformity of the joints with a violation of functionality with hemorrhagic vasculitis does not occur.

Pain in the abdomen is the third most common symptom of hemorrhagic vasculitis. This symptom can occur both in combination with other signs of the disease, and manifest before them.

In this case, some patients complain of moderate pain in the abdomen, not accompanied by digestive disorders, not causing special suffering.

As a rule, such pains pass independently in a couple of days. Other patients complain of pain of a paroxysmal nature, which appear similar to intestinal colic, which do not have exact localization. Such pain attacks can be repeated for several days.

In addition, many patients report a fever, unstable stool, nausea and vomiting. In rare cases, against the background of the above clinical picture of the pathology, episodes of gastric and intestinal bleeding are noted.

Diagnosis of the disease

For this disease, nonspecific changes in laboratory parameters are noted. With hemorrhagic vasculitis, an increase in ESR and leukocyte count may be possible, as well as disproteinemia with an increase in alpha-2 globulin.

An increase in nonspecific indicators is also observed for categories characterizing the presence of the inflammatory process. Immunological changes are expressed as an increase in the level of immunoglobulin A, as well as an increase in the level of circulating immune complexes and cryoglobulins.

There is often a decrease in the level of immunoglobulin G and complement activity. In severe disease, laboratory manifestations of hypercoagulability are noted.

Hemorrhagic vasculitis and pregnancy

As for most autoimmune pathologies, the development of secondary antiphospholipid syndrome( APS) is characteristic of hemorrhagic vasculitis. The latter, in turn, can cause a number of further complications during pregnancy.

So, with APS, placental insufficiency, gestosis, intrauterine growth retardation and fetal growth, infarction and placental abruption can occur.

It is worthwhile to clarify that APS can also develop regardless of the course of the underlying disease, at any time of pregnancy. Specialists recommend conducting an in-depth examination at the ASF and other violations and hand over all relevant analyzes within the framework of such a check. When detecting hemorrhagic vasculitis against the background of pregnancy, the usual method of taking heparin and aspirin in small doses.

Effective treatments for adults

Depending on the condition of the individual patient and the phase of the disease, treatment of this pathology is performed using a variety of techniques. With all forms of such a violation as hemorrhagic vasculitis - treatment involves the use of antiaggregants.

In case of severe disease, two drugs with the same effect can be used to enhance the effect of this technique.

The dosage of anticoagulants is selected individually in each case. When choosing the right dose, specialists are guided by the positive clinical dynamics of existing symptoms, as well as the stabilization of laboratory parameters.

In the absence of the expected clinical and laboratory effect, the dose gradually increases. For example, with an average disease course, treatment usually takes up to 28-30 days. The withdrawal of drugs is also carried out gradually.

Treatment of hemorrhagic vasculitis in children

In severe cases, transfusion therapy is used in children for 1-2 weeks throughout the acute period of the illness, in which the clinical symptoms are as pronounced as possible. In addition, in the severe course of hemorrhagic vasculitis, plasmapheresis is administered.

This procedure is aimed at purifying the blood from toxins, bacteria, antibodies, immune complexes, inflammatory substances and cryoglobulins.

Antihistamines are effective in children who have a history of eating, household or medicinal allergy, exudative-catarrhal diathesis, allergic diseases, etc. Therapy with the use of drugs of this group, usually carried out for 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, complete recovery is noted in 50% of patients.

It is also possible to transfer the disease from acute to long-term recurrent stage, in which the frequency of relapses varies from single manifestations in a couple of years to monthly.

Compliance with the diet

According to experts, the observance of a certain diet with such a disease is simply necessary, as with any disease that affects the gastrointestinal tract.

Therefore, the treatment of hemorrhagic vasculitis begins with the correction of the patient's nutrition.