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What are the symptoms of Henoch Schonlein purpura nephritis

2017-02-18 11:45

Characteristics of symptoms of Henoch Schonlein purpura nephritis

(I) renal manifestations

Purpura nephritis renal involvement rate is extremely high, even if the disease patients urine normal, renal histological examination showed glomerular inflammation and renal symptoms seen in any period of the disease, but with purpura occurred within 4 weeks after the rare, also can appear later, even after the onset of a few months to 2 years only occasionally, a small number of patients, the first hematuria, after a rash and other symptoms, the severity of renal involvement with the skin, joints, there was no significant correlation between the degree of gastrointestinal tract involvement, the main clinical manifestations of renal involvement:
1, hematuria: the most common clinical manifestations of renal involvement was gross hematuria or microscopic hematuria, sustainable or intermittent, children with hematuria than those of adult sees, and intensified in the infection or purpura after seizures, most cases were accompanied with different degrees of proteinuria, hematuria caused by most nephritis, occasionally with ureter, bladder or urethral mucosal surface caused by bleeding.

2, proteinuria: most of the cases have different degree of proteinuria, proteinuria is mostly moderate, quantity is lower than 2g/d, and is not necessarily proportional to the severity of hematuria, serum protein level decreased significantly compared with the degree of proteinuria, the reason may be in addition to the kidney protein leakage, but also from other parts such as the gastrointestinal tract subcutaneous tissue, leaking out, some cases of nephrotic syndrome range proteinuria.

3, high blood pressure: generally mild hypertension, high blood pressure and poor prognosis.

4, others: a minority of patients were mild edema, edema, and proteinuria, gastrointestinal protein loss and capillary permeability changes, renal function is normal, a few appeared a transient increase in serum creatinine.

(two) renal manifestations
1, skin purpura: one of the main basis for clinical diagnosis of this disease is the vast majority of patients with skin purpura as initial symptoms, skin purpura occurs in the distal limbs stretch side, buttocks and lower abdomen, was symmetrical distribution, lesion sizes, bleeding spots, slightly prominent skin, can be integrated into the film, there is itching feeling no pain, but one to relapse repeatedly, also appeared in batches, 1 to 2 weeks after gradually subsided, there are 4 ~ 6 weeks delayed extinction, sometimes partial hives and hemorrhagic maculopapules, angioneurotic edema and other symptoms.

2, joint symptoms: 1/2 ~ 2/3 of patients with joint symptoms occurred in large joints such as the knee, ankle joint, followed by the wrist and finger joints, Changbiaoxianwei joint swelling and tenderness around, but no red, hot, no deformity.

3, the digestive system symptoms: about 2/3 patients with gastrointestinal symptoms, with abdominal colic positioning is more common, medical abdominal tenderness, generally no muscular tension or pain, nausea, vomiting, often with gastrointestinal bleeding, intestinal edema, hemorrhage or stiff form intussusception, intestinal perforation, clinical as hematemesis or melena, there are reports of acute pancreatitis.

4 other features: the history of upper respiratory tract infection may have headaches, fever, malaise, occasional hemoptysis or nasal bleeding, nervous system manifestations were headache, abnormal behavior and convulsions, a minority of patients with myocarditis manifestation.

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