Hemorrhagic Vasculitis

Hemorrhagic Vasculitis (syn: Shenlaine -Henoch disease, capillarotoxicosis, anaphylactoid purpura) is a form of systemic vasculitis with a predominant lesion of small vessels of the skin, abdominal cavity and kidneys.

Etiology and pathogenesis are not well understood. In some cases, the disease is preceded by bacterial (often streptococcal) and viral infections, parasitic infestations, the introduction of vaccines and serums, and the intake of medications. Great importance in the mechanism of development of vasculitis is given to violations of the immune system with the defeat of the walls of predominantly small vessels with immune complexes and the occurrence of increased permeability of the vessels.

Hemorrhagic vasculitis develops at any age; Children and adolescents are more often ill. The main, and in many cases the only clinical symptom, are rashes on the skin (skin syndrome). Characteristic are small bright red and cyanotic-purple papular-hemorrhagic eruptions, localized symmetrically on the anterior surface of the shins, feet, thighs, buttocks, and much less often on the outer surface of the shoulders and forearms. In severe cases, the rashes are necrotic with the formation of ulcers. Typically, the development of migratory arthritis of the ankles and knee joints (articular syndrome). In a number of patients, along with the cutaneous and articular can be observed abdominal syndrome. Due to the defeat of the vessels of the mesentery, intestine and other organs of the abdominal cavity, there are paroxysmal pains in the abdomen, often accompanied by repeated vomiting with an admixture of blood, the presence of blood in the feces is determined. In a number of cases, renal vessels are affected, usually with hematuria, and glomerulonephritis (kidney syndrome) is also possible.

The course of the disease is more often characterized by periods of exacerbations and remission. During an exacerbation, different syndromes (skin, abdominal or renal) may prevail in the same patient at different times. The prognosis in these cases is usually favorable, with the exception of the rare cases of development of chronic glomerulonephritis. Perhaps also acute, sometimes lightning-fast course of the disease, when many internal organs are affected. In some cases, a lethal outcome is possible, especially with hemorrhages in the adrenal glands.

Treatment is carried out in a hospital. In skin and skin-joint syndromes, antihistamines are prescribed, ascorbic acid in high doses, non-steroidal anti-inflammatory drugs (indomethacin, voltaren), nicotinic acid, quarantil, trental. Glucocorticoids are shown only in severe abdominal or renal syndromes.

When abdominal syndrome requires a hunger diet, and then taking semi-liquid food in a cooled form. Patients with hemorrhagic vasculitis are contraindicated in the administration of vaccines and serums.