Vasculitis is a whole group of pathological conditions. They are united by one common characteristic feature - the inflammatory process in the walls of blood vessels, leading to their damage and gradual destruction. Large veins and arteries as well as small capillaries may be at risk. Progressing, the disease affects adjacent tissues and internal organs, which disrupts their normal functioning and upsets the work of the whole organism.
Pathologies affect both men and women of all ages. Especially dangerous are those cases when vasculitis occurs in a child. A young unformed body is not able to cope with the disease on its own. Timely seeking medical help will help to avoid complications.
Varieties of vasculitis
Vasculitis is divided according to a number of signs: the type and degree of vascular damage (arteries, veins, capillaries), the localization of the focus, its size, etc. This makes their classification rather complicated, in addition, it is often reviewed. However, two large groups of vasculitis should be distinguished:
- systemic - lead to damage to tissues and organs due to a violation of their blood supply;
- skin - appear in the form of specific rashes on the skin, rarely leading to complications.
Also, for the main reason for their occurrence, vasculitis is divided into the following groups:
- primary - arising as an independent disease due to a failure of the immune mechanisms;
- secondary - arising against the background of other diseases (infectious, viral, parasitic, etc.).
Vasculitis in a child and an adult is subjected to a single classification.
What is the danger of vasculitis in children?
If vasculitis develops in a child, then the risk of its generalized course, i.e., spread throughout the body, increases. An unformed child’s body cannot cope with the pathological process itself, and the disease progresses rapidly. Therefore, the onset of the disease can occur in acute form. And after recovery, the likelihood of relapse increases.
Fever, worsening general condition, decreased appetite, a characteristic rash that causes unpleasant sensations and itching are signs by which vasculitis in children can be recognized (photo below).
The situation is complicated by the fact that the child begins to comb the problem areas, which injures the skin and provokes the formation of scar tissue. Through wounds, the infection enters the bloodstream, this further worsens the condition and slows down the healing process.
In the presence of complications, any vasculitis can flow into other more severe forms. Then not only skin vessels, but also large and small arteries, and veins of other areas of the body and internal organs are affected. Muscles and joints that do not receive sufficient nutrition and blood supply, gradually atrophy and lose mobility. Such dangers entail vasculitis in a child. Treatment and qualified care should be timely.
Hemorrhagic vasculitis in children
Hemorrhagic vasculitis is also known as Shenlein-Genoch disease. A fairly common disease in children from 4 to 7 years old, but can occur in infants. The reasons for the appearance are the transfer of infectious diseases (viral, bacterial), parasitic infestations, various vaccinations, food allergies.
The first evidence of the manifestation of the disease is a hemorrhagic skin rash of varying degrees of intensity. Most often, it is localized on the lower extremities, near joints, bends. Very rarely, rashes appear on other parts of the body - palms, feet, neck, face. At this stage, the lesion extends to the small vessels of the skin. This is the main symptom by which hemorrhagic vasculitis in children is determined.
Symptoms characteristic of the disease can appear in parallel with a skin rash or at a later date. This is damage to the joints, manifested in the form of pain, inflammation, swelling. It is possible to involve the digestive organs in the pathological process, which is accompanied by heaviness in the abdomen, colic, nausea, and vomiting.
In the 1st or 2nd year of life, the development of a fulminant form is possible, which greatly complicates hemorrhagic vasculitis in children. The causes of the occurrence are the transfer of so-called childhood infections - scarlet fever, chickenpox, rubella, etc. The course of such a disease is always acute, characterized by an excessive manifestation of all symptoms and can be dangerous for an unformed child's body.
Clinical forms
For convenience in clinical practice, hemorrhagic vasculitis is usually divided into the following forms:
- Simple form. Known as cutaneous purpura. It appears in the form of a reddish rash - this is the most basic diagnostic sign and symptom. Most often affects the lower limbs, rarely rises above.
- Cutaneous articular purpura. A more severe form of the disease. In addition to skin rash, joint damage occurs. This is accompanied by pain and swelling. The knee joints are particularly affected, less often the elbow and wrist joints.
- Abdominal purpura (syndrome). Accompanied by pain and pain in the abdomen, vomiting, nausea. If only this symptom is present, it is extremely difficult to diagnose hemorrhagic vasculitis in children. The causes of the disease are damage to the organs of the abdominal cavity, namely the gastrointestinal tract.
- Renal syndrome. Often develops against the background of other signs of the disease.
- Mixed form. It can combine 3 signs at the same time or all.
- Rare forms. Expressed in the defeat of the lungs, nervous system, genitals. Found in isolated cases.
Causes of occurrence
Hemorrhagic vasculitis is classified as an immunocomplex disease. In its occurrence and course, immune complexes are involved - antigen-antibody compounds (AG - AT) circulating in the blood.
Their appearance is considered a response to the penetration into the body of foreign or pathogenic agents - fragments of cells, toxins, bacteria, microscopic fungi, viruses, protozoa (parasites). That is why hemorrhagic vasculitis usually develops a few weeks after the transfer of an infectious disease or vaccination.
Usually, the AT - AG complexes are destroyed by special blood cells - phagocytes. But sometimes they can accumulate in the bloodstream, “settle” in adjacent tissues and organs, cause inflammation. In addition to the occurrence of AG - AT complexes, the permeability of the vessel walls increases, and the complement system , proteins involved in the immune response, is activated. These parameters are laboratory diagnostics.
Diagnosis of the disease
Vasculitis in a child is diagnosed by the following signs:
- The presence of skin rashes of lilac and red shades. Spots of small diameter, convex. They can occur on any part of the body, but most often on the lower extremities.
- Abdominal (from lat. Abdomen - stomach) pain. May have an intermittent nature, amplified every time after eating.
- A biopsy (examination of a tissue fragment) of the walls of venules or arterioles shows an increase in the number of granulocytes.
Laboratory data are not diagnostically significant in this case. However, attention is drawn to the increase in the number of type A immunoglobulins in blood serum. Also important indicators can be the high titer of AntiStreptoLysin-O (ASL-O) and the erythrocyte sedimentation rate (ESR), which are used to diagnose vasculitis in children.
Forecasts may be favorable. In some cases, all symptoms disappear after about 30 days after the acute manifestation of the disease. However, there is a risk of developing kidney failure, complications of the gastrointestinal tract, or damage to the central nervous system.
Hemorrhagic vasculitis in children: treatment
Treatment of hemorrhagic vasculitis begins only after the specialist’s final diagnosis and causes of the disease. Therapy will depend on the phase of the disease and the degree of its development.
In any case, restrict motor activity. This is especially important during the acute course of the disease. Bed rest is prescribed up to a stable disappearance of skin rash. Its average duration is approximately 3-4 weeks. Violation of this condition can provoke repeated hemorrhagic rashes. If complications occur and the acute course of the disease, bed rest is prolonged.
Be sure to prescribe a diet with strict exclusion from the diet of allergenic and potentially allergenic products. If the disease proceeds in the form of an abdominal syndrome, then diet No. 1 is prescribed. If the situation is complicated by severe jade, diet No. 7 (exclude salt, meat, cottage cheese). Such a diet will reduce the unpleasant manifestations that hemorrhagic vasculitis in children leads to.
Treatment, regardless of the form of the disease, includes the use of antiplatelet agents - drugs that reduce blood clots, as well as fibrinolysis activators - substances involved in the "dissolution" of blood clots. The composition and quantity of medicines, their dose and duration of administration are approved by the attending physician.
Since the onset of the disease is associated with the triggering of immune mechanisms, the treatment consists in removing the AG - AT complexes from the body. In severe cases of the disease and the absence of contraindications, blood is mechanically cleaned - plasmapheresis. This procedure will remove not only immune complexes from the blood, but also pathogenic bacteria, microscopic fungi, toxins.
Allergic vasculitis in children
The cause of this disease is an allergic reaction. As a rule, this is an immune response to medicines, food or infection in the body. The result is inflammation and vascular damage, mainly in the skin. Most often develops in children under 15 years after the transfer of infectious diseases or a course of drug treatment. Sometimes the cause of allergic vasculitis in children may not be clear. Then a thorough study of the medical history is necessary.
The main symptom is an extensive rash that causes itching. It has the appearance of spots and / or convex tubercles of violet or red-lilac color over large areas of the skin. They mainly appear on the legs, hips, buttocks. Perhaps the formation of blisters and ulcers, scarring of damaged vessels. Usually, allergic vasculitis resolves on its own within a few weeks. However, complications in the form of damage to internal organs due to a violation of their blood supply are possible.
Varieties and forms
Depending on the diameter of the affected vessels, distinguish:
- superficial (dermal) allergic vasculitis - affects the capillaries, arterioles and venules that lie in the skin;
- deep or dermo-hypodermal - occurs when medium-sized arteries and veins are involved in the pathological process.
Depending on the stage of development of the skin rash, several forms of the disease are distinguished:
- papular - rashes are convex, palpable, pigmented;
- vesicular - vesicles (vesicles) with liquid contents form;
- pustular - cavities filled with pus appear;
- ulcerative - in place of pustules necrotic ulcers occur;
- cicatricial - accompanied by scarring of damaged skin.
Allergic vasculitis treatment
It aims to reduce inflammation by taking medications. The complex therapy also includes the use of drugs that reduce the formation of blood clots (antiplatelet agents), increase vascular tone, and antihistamines to reduce allergic manifestations. If the disease is recurring in nature, you can not take medications used earlier, it is possible that the body has developed resistance to them.
To exclude the influence of food allergic agents, enterosorbents are prescribed. These drugs bind and remove toxins from the intestines, preventing them from entering the bloodstream. In addition, a strict diet with the exception of foods that can cause an immune response is required. These are mandatory measures when vasculitis is diagnosed in children.
The causes of the disease can be varied. Sometimes, if necessary, exclude medications and drugs that can lead to an allergic reaction. The duration of therapy depends on the nature of the course of the disease (undulating or recurring).
What is important for parents to know?
Parents need to be very careful about any rashes on the skin of the child. Even those that seem insignificant at first glance. It is important for parents to understand that vasculitis in a child can occur in waves: periods of remission are followed by relapses. Moreover, the symptoms of a newly appeared disease may differ from those that were previously. Timely seeking medical help will help to avoid unpleasant consequences.
You should not prescribe treatment yourself if vasculitis has been suspected. In children, the symptoms of the disease may be ambiguous. Diagnosis and treatment should be carried out by a qualified specialist. Especially, one should not show independence in the choice of immunostimulating and immunomodulating drugs. After all, the main reason for the appearance of any form of vasculitis is a violation of the protective functions of the body.
Compliance with simple measures will help prevent the recurrence of an ailment in a child:
- limiting the number of stress factors;
- providing a healthy diet, an active lifestyle;
- the presence of light physical exertion;
- strengthening immunity.
It is important to understand that diseases carried by a child at an early age can adversely affect his physical and mental development.