Medical history (history of illness) represents an important component in the diagnosis of Schönlein-Henoch purpura. Family history What is the general health status of the relatives? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Current medical history/systemic history (somatic and psychological complaints). Have you noticed … Schönlein-Henoch Purpura: Medical History
Blood, hematopoietic organs-immune system (D50-D90). Hemolytic uremic syndrome (HUS) – triad of microangiopathic hemolytic anemia (MAHA; form of anemia in which erythrocytes (red blood cells) are destroyed), thrombocytopenia (abnormal decrease in platelets/platelets), and acute kidney injury (AKI); Mostly occurring in children in the context of infections; most common cause of acute renal failure requiring dialysis … Schönlein-Henoch Purpura: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by Schönlein-Henoch purpura: Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Ileus (intestinal obstruction) Ischemia (reduced blood flow) in a section of the intestine. Perforation (rupture) of the intestine Ulcus ventriculi (stomach ulcer) Genitourinary system (kidneys, urinary tract – reproductive … Schönlein-Henoch Purpura: Complications
Schönlein-Henoch purpura is classified as follows: Palpable (palpable) purpura (small-spotted capillary hemorrhage in the skin, subcutaneous tissue, or mucous membranes) or petechiae (pinpoint hemorrhage of the skin or mucous membranes; considered an obligatory criterion), predominantly of the legs plus one of the following criteria (sensitivity (percentage of diseased patients in whom the disease is detected … Schönlein-Henoch Purpura: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Of the skin, mucous membranes [purpura (spontaneous, small-spotted hemorrhages of the skin, subcutaneous tissue, or mucous membranes); petechial hemorrhages (pinpoint hemorrhages of the skin), especially on … Schönlein-Henoch Purpura: Examination
Pathogenesis (disease development) It is likely that Schönlein-Henoch purpura is a genetic-based immunopathologic reaction triggered by various triggers (elicitors), such as infections or medications. The disease is often preceded by an upper respiratory tract infection. In half of the cases, this is influenza A (flu/viral illness). The allergic immune complex reaction is classified as a … Schönlein-Henoch Purpura: Causes
General measures In acute relapse: physical rest and bed rest. Avoidance of tight-fitting clothing If joints are swollen: Cooling If fever occurs: Bed rest and physical rest (even if fever is only slight; if aching limbs and lassitude occur without fever, bed rest and physical rest is also required). Fever below 38.5 °C does not … Schönlein-Henoch Purpura: Therapy
Laboratory parameters of 1st order – obligatory laboratory tests. Small blood count [leukocytosis and thrombocytosis/increased white blood cell (leukocyte) and platelet (thrombocyte) counts] Inflammatory parameters – ESR (erythrocyte sedimentation rate) [moderately increased] or CRP (C-reactive protein) [moderately increased]. Granulocyte cytoplasmic antibody (ANCA). Antinuclear antibodies (ANA) Detection of circulating immune complexes. Complement levels often elevated initially … Schönlein-Henoch Purpura: Test and Diagnosis
Therapeutic targets Improvement of the symptomatology Avoidance of complications Therapy recommendations Local therapy: antiphlogistic (anti-inflammatory)-antimicrobial. Systemic therapy Corticosteroid therapy for severe forms, progression (progression) and extracutaneous manifestation. In proteinuria (increased excretion of protein in the urine): If persistent (persistent) for more than 6 weeks: Small proteinuria (protein excretion <3.0 g/d): ACE inhibitor or angiotensin 1-(AT-1) … Schönlein-Henoch Purpura: Drug Therapy
Obligatory medical device diagnostics. Abdominal ultrasonography (ultrasound examination of abdominal organs) – to exclude intestinal wall hemorrhage, intussusception (invagination of a portion of the intestine into the aborally following intestinal segment). In case of arthritis (joint inflammation)/arthralgia (joint pain): sonography (possibly magnetic resonance imaging, MRI) of the affected joint – to exclude septic arthritis. X-ray … Schönlein-Henoch Purpura: Diagnostic Tests
To prevent Schönlein-Henoch purpura, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Food Allergens Medications Analgesics (painkillers) Non-steroidal anti-inflammatory drugs (anti-inflammatory drugs; e.g., ibuprofen, acetylsalicylic acid, diclofenac, indometacin). Antibiotics (e.g. sulfonamides).
The following symptoms and complaints may indicate the presence of Schönlein-Henoch purpura: The diagnosis is classically made in the presence of the following symptom triad. Hemorrhagic exanthema (“bleeding rash”)/palpable (palpable) petechiae or purpura/ (see skin below) [obligatory!]. Arthritis (inflammation of the joints) Colicky abdominal pain (angina abdominalis) The five most common manifestations are: 1. skin … Schönlein-Henoch Purpura: Symptoms, Complaints, Signs