Shenlein-Genoch disease, or hemorrhagic vasculitis, is an inflammatory disease that affects not only the human vascular system, but also the skin, joints, gastrointestinal tract, and renal glomeruli. This pathology is equally developed both among children and among adults. Diagnosis is based on various research methods, and treatment of vasculitis involves the use of anticoagulants.
What it is
Vasculitis is one of the most common hemorrhagic diseases. In most cases, this pathology is equated with an allergic type of superficial nature, which affects small arteries and veins, as well as capillaries. Mostly hemorrhagic vasculitis is diagnosed in children, whose age category is in the range of 4-13 years. Children 6-13 years old are most susceptible to the inflammatory process.
The disease proceeds in stages and is accompanied by severe symptoms. It arises as a result of various provoking factors that can only be established after a thorough examination. As for the treatment of vasculitis on the legs and other parts of the body, it is long-term and is selected for each patient individually. Do not engage in self-treatment, as this can lead to irreversible consequences.
Classification
In modern medicine, there is a certain classification of this disease, which is recommended to adhere to when making a diagnosis. So:
- Clinical course: acute phase (the onset of the disease or an exacerbation period) and the phase of subsidence (improvement in general condition).
- Forms, according to the symptoms: simple, articular, abdominal, fulminant.
- By severity: mild, moderate, severe. Each of the degrees is represented by a specific symptomatology.
Also, by the nature of the course, the pathology happens: acute (up to two months), prolonged (up to 6 months), chronic.
Development reasons
In order for the treatment of vasculitis to be effective, it is worth correctly identifying the provoking factor. The underlying cause of modern medicine has not yet been established, but there are opinions that pathology can develop as a result of:
- Respiratory diseases, especially after tonsillitis or scarlet fever.
- An allergic reaction of the body to food or drugs.
- Poor vaccination.
- Hypothermia.
- Insect bite.
Also, immune disorders can provoke the development of vasculitis.
Symptomatology
All the symptoms of hemorrhagic vasculitis are combined into groups of syndromes. These include the following:
- Skin syndrome. The patient develops hemorrhages of a small size, which rise above the skin. May be observed in the area of joints, hands, feet, hips, buttocks, face, or throughout the body. After the patient gets rid of the hemorrhage, pronounced pigmentation remains in his place. It is also worth noting that with this type of pathology, the patient has no blood flow from the nose and mouth.
- Joint Syndrome. It manifests itself in the form of pain and swelling in the joints, especially on the legs. In this case, the discomfort may increase during a hemorrhage under the skin. The skin above the joints changes color. This condition can be observed within 5-7 days. It should be noted that there is no persistent change in the shape of the joints with a violation of their functionality.
- Abdominal syndrome. It may be accompanied by an outpouring of blood in the intestine and peritoneum. In this case, the patient will complain of pain of an intense, paroxysmal nature, which are noted in the navel. The skin of the patient becomes pale, his face is thin, his eyes are sunken, there is a dry tongue. The patient in this condition is restless, can only lie on his side. Along with the pain, vomiting and diarrhea with bloody impurities appear. Discomfort goes away on its own or after the first days of treatment of vasculitis.
- Renal syndrome. In this situation, damage to the small vessels of the kidneys is noted. In this case, the patient has blood in the urine, high blood pressure and swelling.
If the patient begins to develop anemia on the background of vasculitis, then signs such as malaise, decreased performance, dizziness, fainting, tinnitus, tachycardia without good reason, stitching pain in the chest can be noted. Treatment of vasculitis in adults is based on the elimination of symptoms and the solution of other problems.
Diagnostics
After the patient turned to a specialist, he is examined, an analysis of the course of the disease and complaints. Then attention is paid to the quality of life. The doctor should find out whether there are chronic diseases, hereditary pathologies, whether the patient suffers from bad habits, whether he is taking drugs, or if he was vaccinated in the near future.
Without fail, such types of examinations are prescribed to the patient as:
- Blood analysis. At the initial stage of vasculitis, indicators remain unchanged. Then deviations, such as an increase in the number of white blood cells and ESR, a decrease in red blood cells and hemoglobin, can occur.
- Urinalysis and feces. With the progression of pathology, a bloody impurity will be noted in the biological material.
- Blood biochemistry. Determines the level of cholesterol, sugar, creatinine, urea, electrolytes. This analysis helps to identify existing pathologies.
- Immunological and virological research.
Attention is drawn to the duration of bleeding in a patient and blood coagulation. A pinch, tourniquet, cuff test may be performed. Also, do not exclude an ultrasound examination of the abdominal organs, a kidney examination, a biopsy of the skin, endoscopy, FEGDS, colonoscopy, bronchoscopy, laparoscopy, bone marrow examination, trepanobiopsy.
Differential diagnosis
Treatment of hemorrhagic vasculitis in adults will be effective only if not only diagnosis is carried out, but also attention is paid to differential research. The previously listed symptoms occur not only with this disease, therefore, consultation of many narrow-profile specialists is required. Vasculitis should be distinguished from such abnormalities and conditions as:
- Infectious endocarditis.
- Systemic vasculitis.
- Diffuse pathologies of connective tissue.
- Meningococcal infection
- Cryoglobulinemic vasculitis.
- Yersiniosis.
Also, vasculitis is often confused with Crohn's disease.
Vasculitis treatment
A photo of the pathology is presented above in the article. The treatment of the disease will depend on many factors. For example, from the phase, clinical form, severity of manifestations and the nature of the course. Only a specialist can determine these data after a thorough and lengthy examination.
A patient with this type of vasculitis may be prescribed:
- The antiplatelet agents are Curantil and Trental. If the disease is severely neglected, then two drugs are prescribed immediately. Can be used analogues of these drugs. The dose is selected individually. If there is no positive effect of therapy, then the portion of drugs increases.
- Fibrinolysis activators. Dosage is selected taking into account individual susceptibility.
- Glucorticosteroids. They are prescribed only for severe course of pathology.
- Cytostatics. They are prescribed to the patient with severe course of vasculitis, as well as with kidney damage, the presence of severe skin syndrome.
- Antihistamines. In most cases, they are prescribed for the treatment of vasculitis in children who suffer from a different type of allergic reaction.
- Enterosorbents.
- Membrane stabilizers.
Plasmapheresis can also be prescribed. It normalizes blood properties, eliminates spasms in blood vessels, improves microcirculation, increases the activity of immunological cells and the patient's susceptibility to drugs.
The duration of treatment for vasculitis will depend on the severity and clinical form. In a neglected case, therapy may drag on for a year. If the patient has a chronic stage, then repeated courses are carried out every 3-6 months.
Complications
If treatment of vasculitis on the legs is excluded, then this can lead to certain problems. As for the outcome in children, in most cases it is favorable. If therapy was not delivered on time, then the disease develops into a chronic form and is accompanied by skin and articular syndrome. Kidney damage may also occur, over time, the functionality of which is impaired. As for chronic renal failure, it is diagnosed in rare cases.
Preventive actions
Prevention of vasculitis is mandatory. Experts recommend following these tips:
- Strengthening immunity.
- Timely detection and treatment of infectious diseases.
- Refusal to take unnecessary medicines.
- Do not overcool.
- Refusal of excessive physical activity.
- Early diagnosis of vasculitis. Symptoms and treatment of this pathology are always related.
- Exclusion of contact with substances and components that can provoke an allergic reaction of the body.
- If the disease is already progressing, then vaccination should be excluded as a preventive measure.
- Refusal from smoking and drinking alcohol.
If you adhere to these recommendations, the disease will not disturb and will not develop into a chronic stage.
Vasculitis in children
As mentioned earlier, this type of vasculitis is more common in children than in adults. In most cases, it is diagnosed in boys. It can occur in the acute, prolonged or chronic phase.
In medicine, such forms of childhood vasculitis are distinguished:
- Simple.
- Rheumatoid.
- Lightning fast.
- Abdominal.
Such factors as hypothermia, trauma, taking and intolerance to drugs, an allergic reaction of the body, and a vaccine of poor quality can provoke vasculitis in a child.
Pathology is also accompanied by severe syndromes:
- In most cases, there is a skin syndrome, it can be supplemented by articular, which is rarely persistent.
- Also, for children with this diagnosis, abdominal syndrome is also typical, which lasts several days. Hemorrhagic vasculitis can provoke many diseases of the abdominal cavity.
- As for the vascular syndrome, it rarely occurs.
Diagnosis is carried out, as in adult patients. Attention is also paid to the differential type of research.
Treatment of childhood vasculitis
Treatment of children with this pathology is carried out in a hospital. When there is an improvement, the therapy continues at home. Bed rest with vasculitis is recommended for at least 23 days.
The therapy itself is complex, a strict diet is necessarily prescribed. Allergens are excluded from the diet. During the treatment of vasculitis on the legs (see photo of the disease above) and other parts of the body, various drugs are used. Children are not allowed to prescribe sulfonamides, antibiotics, ascorbic acid and calcium supplements. The basis is heparin therapy. They can prescribe Prednisolone, vascular preparations, antiplatelet agents, and sorbents. If the disease progresses, plasmapheresis is recommended.
If treatment of hemorrhagic vasculitis in children is delayed, complications such as perforation, intussusception, bleeding in the gastrointestinal tract, peritonitis, and acute anemia may occur.