Werlhof's disease (idiopathic thrombocytopenic purpura)

Represents a symptom pathological condition called thrombocytopenia. It is associated with a reduced number of platelet cells in the composition peripheral blood.

Thrombocytopenia appears various diseases blood and is accompanied by hemorrhagic blood syndrome of the petechial-bruise type, i.e. like purpura.

Classification of the disease

1. Thrombocytopenic syndromes of congenital hereditary nature: thrombocytopenia with absence radius, Wiskott-Aldrich syndrome, Hegglin syndrome, Bernard-Soulier syndrome.

2. Thrombocytopenia is congenital, but not hereditary. Occurs as a result of intrauterine infectious lesions fetus, such as rubella or chickenpox. Immune thrombocytopenia occurs in the mother with antibodies through the placenta. Alloimmune purpura forms in newborns when the children's platelets inherit antigens that the mother does not have.

3. Acquired thrombocytopenia. The disease can be presented in several forms: immune, when autoimmune idiopathic purpura and infectious disease clinics predominate (HIV infections, mycoplasma, malaria, etc.); thrombotic purpura; hypersplenism; DIC syndrome (consumption syndrome); massive transfusion syndrome; thrombocytopenia in pregnant women.

Symptoms and signs

To date, the causes of the disease are not clear. On initial stages Purpuras of this type are formed by platelet microthrombi, spreading into small vessels(capillaries and arterioles) throughout the body, especially affecting the brain, kidneys and liver, resulting in disruption of blood flow and damage to cells and tissues.

Thrombocytopenic purpura manifests itself in a complex manner and includes a number of signs: a low platelet count in the blood, the presence of hemolytic anemia, neurological changes, impaired renal function, and the appearance of a febrile state.

In the case of the acquired form, it often occurs allergic purpura or Schonlein purpura. In most cases it is affected circulatory system children aged 3-7 years. No specific signs of the disease have been identified to date, but ESR indicators in the blood correlate with the acute degree of vasculitis.

Pigmented chronic purpura has a polymorphic nature of symptoms, but there are symptoms characteristic exclusively of it: the presence of erythema, pigmentation and hemorrhage, the degree of which depends on the level of vascular damage. Such purpura is accompanied by itching and has a recurrent nature: each time it is localized to all larger surface, the rash becomes brighter in color.

Hemorrhagic form of purpura manifests itself as a rash similar to the rash associated with diathesis, but gradually merging into large spots. The rashes are distributed on the limbs, less often on the torso. It is the skin rash that is the only sign of the disease.

Possible complications

For purple heavy bleeding possible during abdominal surgery, tooth extraction and during childbirth.

Causes of the disease

Appearance vascular purpura associated with dysfunction blood vessels in hemostasis. More often vascular purpura is congenital and appears as a hemangioma. Such spots appear in every tenth newborn and eventually disappear or are removed with a laser.

At congenital purpura genetic Marfan syndrome or Ekhlar-Danlos. In such cases, complex violations are identified connective tissue, as a result of which blood vessels, especially arteries, also receive defects.

Reasons allergic purpura are inflammatory processes in the capillaries, but their etiology still remains unknown. There are assumptions about the influence of factors environment, nutrition and infectious diseases.

Specific symptoms of purpura include the appearance pain in the joints, inflammatory processes in the esophagus, as well as neurological symptoms.

Appearance vascular purpura common in older people. Sometimes it is also called senile pigmentation. The appearance of the disease is associated with wear and tear of blood vessels, deterioration of their functioning, especially in areas that are especially susceptible to ultraviolet radiation (limbs, face).

Rashes and spots may become more intense due to increased blood pressure. Most often, the reason lies in a sudden complication caused by a blood clot formed in a vein, a sudden lifting of a heavy load, severe cough, during the pushing period during childbirth and even vomiting. Vascular regeneration can occur without the use of drug treatment.

Diagnosis and treatment

1. The level of thrombocytopenia in the peripheral blood test is below 100.0×109/l.
2. Autoantibodies to platelets are present.
3. Signs of diseases such as anemia and acute leukemia, which are characterized by impaired hematopoietic functions.
4. You are not taking medications that can cause thrombocytopenia.
5. Content of megakaryocytes in structures bone marrow fine. But there is one peculiarity - bone marrow puncture is possible only if the patient has reached the age of 60 or a splenectomy is required.

Purpura, which does not cause inconvenience to the patient and is not accompanied by serious changes in the composition of the blood, does not require specific treatment. In this case, there is a need for constant monitoring by the attending physician.

When bleeding occurs, local hemostatic medications (creams, ointments), as well as hormonal agents, are prescribed.

An effective treatment method is blood and/or platelet transfusion.

If bleeding becomes systematic, and the use of medications does not produce results within six months, then splenectomy is prescribed. Removal of the spleen is a drastic method, which is resorted to when there is a threat of hemorrhage in the brain.

Before the operation, a medical examination is required and an examination of the organs is prescribed. abdominal cavity and chest, a repeat blood test is given. The doctor may additionally prescribe: x-rays, ECG, magnetic resonance imaging.

Brief interesting data
- Idiopathic thrombocytopenic purpura before the age of 10 occurs with the same frequency in boys and girls, and after 10 years in adults, and many times more often in women than in men.
- Purpura most often appears in spring and autumn.
- Possible in 10% of cases death, associated not with purpura as a disease, but with its consequence - hemorrhage in the brain. This is due to the fact that patients delay the period of contacting specialists.

Splenectomy is performed under general anesthesia. Either laparoscopy or abdominal surgery depending on the indications and capabilities of the medical institution.

Full recovery after such an operation occurs after 1-1.5 months. After surgery, the risk of infection increases, so regular vaccination against influenza virus and other infections is required as prescribed by a doctor.

After a course of treatment or discharge from hospital, it is necessary to adhere to a certain daily routine in order to avoid recurrent manifestations.

It is important to establish a proper sleep and wakefulness regime (you should rest at least 8-10 hours a day); do daily morning exercises (about half an hour) and water treatments as warm shower; study physical exercise, avoiding overloads; set aside 1-2 hours for nap; should get into the habit of going for daily walks fresh air(at least 1.5 hours); Avoid direct sunlight.

Particular attention should be paid to the issue of nutrition: food should be taken in small portions 5-6 times a day. First of all, the diet includes proteins (fish, white meat), plant foods and dairy products.

A necessary component should be seasonal berries, vegetables and fruits, as well as all kinds of non-carbonated and soft drinks(mousses, compotes, herbal teas).

The prognosis for recovery is quite favorable if a competent treatment program is developed and all the instructions of the attending physician are followed. Deaths are possible only in rare cases and are associated with the fact that patients delay the period of treatment medical institutions and bleeding occurs in the brain.

Prevention

Preventive measures regarding relapses come down to maximum avoidance viral infections and prevention of bacterial diseases.

It is necessary to get hit by straight lines as little as possible Sun rays, but it is better to completely eliminate such situations.

Besides, preventive actions consist of the maximum possible elimination foci of infection: caries, tonsillitis, etc.

Traditional methods of treatment

For bleeding and to strengthen the immune system during purpura, take an infusion of rose hips. Cup dried berries pour 1 liter of boiling water and infuse for 10-12 hours (it is good to brew the infusion overnight). Drink during the day instead of tea. You can add honey or a small amount of Sahara.

The tincture is useful for external use. Japanese Sophora. The composition is prepared as follows: 1 teaspoon of fruit is poured into 100 ml of boiling water, infused for 1-1.5 hours, filtered. The affected areas are lubricated with tincture in the morning and evening.

Also we'll talk about the features of thrombocytopenic and idiopathic purpura in children.

Reasons for the development of the disease

The reason for the development of purpura is the tendency to bleed. The release of blood is caused by violations of its coagulation or high pathological permeability of small blood vessels.

These disorders can occur as a result of many reasons:

• pathological changes in the platelet unit;
• consequences of some allergic reactions;
• blood clotting disorders after exposure to toxic substances - bacterial toxins, chemical substances, medicines;
• vascular diseases of inflammatory nature;
• blood stasis.

Types of disease

There are the following types of purpura:

Thrombocytopenic purpura

Thrombocytopenic purpura is a disease characterized by a tendency to bleed due to a decrease in the level of platelets in the blood. This type of purpura is the most common disease related to hemorrhagic diathesis. The disease usually first appears in childhood. Among the adult population, purpura is more common in women.

Depending on the duration and nature of the course, the following forms of the disease are distinguished:

• acute – characterized by a decrease in the number of platelets in the blood to less than 150x109/l for six months from the onset of the disease;
• chronic - develops if the platelet level does not recover within six months;
• recurrent purpura - manifested by a repeated decrease in platelet levels after its recovery.

The exact cause of the development of thrombocytopenic purpura has not been established. Experts point to possible factors risk of illness: previous viral or bacterial infection, hypothermia or overheating in the sun, taking certain medications, surgical interventions and injuries.

Under the influence of these factors, the level of platelets in the blood decreases or antibodies to platelets are formed. Appearing antigens (viruses, drug components) attach to platelets. As a result, the body begins to produce antibodies and tries to destroy antigen complexes with platelets in the spleen. Because of this, the lifespan of platelets is significantly reduced. A decrease in their level in the blood contributes to damage to the walls of blood vessels. As a result, bleeding occurs, the contractility of blood vessels changes, and the formation of blood clot. This is how thrombocytopenic purpura develops.

Symptoms of the disease are spotted bruises on the skin and hemorrhages in the mucous membranes. The rash comes in different shades, from yellow to bluish, and of varying sizes. It resembles painless bruises that are located asymmetrically. Most often, the rash appears at night without previous injury.

In addition to the skin and mucous membranes, hemorrhages occur in the fundus, sclera, vitreous, eardrum. A rare hemorrhage in the human brain is quite dangerous. It is preceded by headache, dizziness, bleeding in some organs.

Thrombocytopenic disease comes in three varieties:

• thrombotic purpura;
• idiopathic purpura;
• vascular purpura.

In idiopathic purpura, platelets are destroyed as a result autoimmune process caused by viruses or taking certain medications. With this type of purpura, rashes in the form of bruises and petechiae predominate. They appear mainly on the child’s legs as a result of even minor bruises.

Thrombocytopenic purpura in children

Thrombocytopenic purpura in children ranks first among hemorrhagic diseases. It most often occurs in girls under 14 years of age.

In children under two years of age, this disease is severe course. It begins acutely, without a previous infectious disease.

Thrombocytopenic purpura in children is often caused by previous vaccinations, especially BCG (tuberculosis vaccine).

Symptoms of idiopathic purpura in children include hemorrhages and bleeding, which most often appear on the mucous membrane of the nose and gums. In girls of puberty, the disease often causes heavy uterine bleeding.

Idiopathic purpura in children and adolescents it often causes the development dangerous disease– hemorrhagic syndrome. It's dangerous frequent bleeding from the mucous membranes of the nose, hemorrhages in the joints and skin, gastrointestinal bleeding.

Treatment of purpura

The main goal of treating purpura is to reduce the production of antiplatelet antibodies and prevent them from binding to platelets.

Drug therapy consists of the use of the following medications:

• glucocorticosteroids – Prednisolone, Hydrocortisone;
• immunoglobulins – Octagam, Intraglobin F, Normal human immunoglobulin;
• interferon alpha - used when glucocorticoid therapy is ineffective;
• pink periwinkle alkaloids – Vinblastine, Vincristine;
• Danazol;
• Cyclophosphamide;
• Azathioprine.

In case of bleeding, hemostatic drugs, aminocaproic acid, are used. At uterine bleeding women are prescribed oxytocin.

If there is a possibility of bleeding in the brain, platelet infusion (infusion) is used to treat purpura. Therapeutic effect This procedure is temporary.

Surgical treatment of purpura involves removal of the spleen (splenectomy). Surgery is performed if there is no effect from conservative therapy, there is a risk of severe bleeding.

A frequently used method for treating purpura is plasmapheresis: purification of blood plasma from antibodies and toxins by filtration using special devices.

When treating purpura vascular type The patient is prescribed a hypoallergenic diet.

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

Purpura

Classification of the disease

Symptoms and signs

Possible complications

Causes of the disease

Diagnosis and treatment

2. Autoantibodies to platelets are present.

3. Signs of diseases such as anemia and acute leukemia, which are characterized by impaired hematopoietic functions, are excluded.

4. You are not taking medications that can cause thrombocytopenia.

Treatment of purpura is primarily aimed at correcting the hemorrhagic syndrome, and only then at increasing the number of platelets in the blood. This is due to the fact that patients in most cases are resistant to low platelet counts, but the side effects of therapy can be more serious than the consequences of purpura.

Idiopathic thrombocytopenic purpura occurs with equal frequency in boys and girls before the age of 10, and in adults after 10 years, and many times more often in women than in men.

Purpura most often appears in spring and autumn.

In 10% of cases, death is possible, associated not with purpura as a disease, but with its consequence - hemorrhage in the brain. This is due to the fact that patients delay the period of contacting specialists.

Immediately before the operation, the patient is vaccinated in order to prevent possible inflammatory processes after removal of the spleen.

Purpura - types, symptoms, treatment. Allergic vasculitis

Purpura is a hemorrhagic accumulation of blood in tissues, under the skin and mucous membranes. It is expressed in spontaneous bruises, ecchymoses, petichiae and small spots appearing on the surface of the skin.

Exist different kinds purpura, however, in medical terminology and statistics, the most common can be considered primary (idiopathic) purpura and secondary, that is, symptomatic. The latter are caused by third-party factors, for example, diseases, infections.

Causes and diagnosis of purpura

Purpura can be thrombocytopenic or non-thrombocytopenic. In the first case, the number of platelets circulating in the blood decreases, in the second, the platelet indicator remains unchanged.

Diseases that cause purpura: multiple myeloma, leukemia, diseases of the bone marrow or spleen, infectious diseases, for example, German measles or rubella. Purpura can also appear under the influence of narcotic drugs or aggressive chemicals.

The external manifestations of all types of purpura are quite similar. In order to distinguish the different types of purpura, it is necessary laboratory analysis. Standard symptoms these are: hemorrhages under the skin, bruises, petechiae (red spots with fuzzy edges). The acute form is accompanied by hematuria and nosebleeds, while the temporary coagulation index is normal.

For proper treatment physicians need to know the type of purpura. For this purpose we are studying external signs and is carried out laboratory diagnostics. For thrombocytopenic purpura, patients are administered corticosteroids. In some cases, splenectomy (removal of the spleen) is indicated. Idiopathic purpura may disappear spontaneously, especially in children.

General measures to prevent purpura: protection from shock, injury, transfer planned operations, tooth extraction.

Types of purpura, symptoms and treatment

Henoch-Schönlein purpura (vascular, allergic, anaphylactoid)

Henoch-Schönlein purpura (there are also references to this type of purpura as vascular, anaphylactic or allergic, which is essentially the same thing, and various specialists may identify this type of purpura differently).

In approximately two thirds of cases, the disease appears after infection of the upper respiratory tract, skin symptoms appear on average ten days after respiratory symptoms. Despite the popular theory about transmission infectiously, no microorganism or environmental factor has been identified as a reliable cause of Henoch-Schönlein purpura.

A distinctive feature of this type of disease is inflammation of blood vessels in upper layers skin. Other symptoms: arthritis, kidney inflammation, abdominal pain. In 90% of cases, the disease is diagnosed in children and resolves within a few weeks. Diseases in adults are more serious, symptoms last longer, and there is a risk of irreversible kidney damage, but its probability is about 5%.

Treatment is carried out with non-steroidal anti-inflammatory drugs.

Hemorrhagic purpura is associated with inflammation of the blood vessels - vasculitis, and occurs as a result of an incorrect response immune system body for infection. Horses often suffer from this disease. Cases have been recorded when hemorrhagic purpura was a consequence of bacterial and viral respiratory tract infections. Symptoms are similar to other types of disease, but can be severe, including necrosis of the affected tissue, consequences for the muscles, kidneys and lungs.

Widespread involvement of the body in pathological process can lead to symptoms such as laminitis, colic, weight loss, and central nervous system dysfunction.

Treatment consists of eliminating the root cause of the disease; dexamethasone, corticosteroids, and immunosuppressive therapy are prescribed.

Nonthrombocytopenic (idiopathic) purpura

Nonthrombocytopenic purpura is allergic reaction unknown origin, causing the appearance red spots on the skin. Often painless, but unaesthetic. Occurs as a result of rupture of capillaries, as a result of which a small amount of blood is released under the skin in the legs, arms, back or absolutely any part of the body. This blood is not absorbed, but accumulates in the tissues. This happens because the capillaries are blocked by protein complexes formed during an abnormal immune reaction. Boys suffer from this disease more often than girls. Peak time of purpura - s late autumn until winter.

Symptoms of nonthrombocytopenic purpura

Headache, fever, loss of appetite, itchy skin, red rash. This rash is red, flat or slightly raised above the surface of the skin, and may be small sizes like freckles, or a little more like a bruise. Initially, the rash turns purple, and then within 24 hours it becomes the color of rust and disappears after a few weeks. Places of occurrence: buttocks, abdomen, lower limbs.

Additional symptoms: muscle pain, swelling of the ankles and knees, blood in the urine, low volume of urine, kidney damage. Due to capillary obstruction, there may be renal failure. Sometimes male patients may experience swelling of the scrotum.

Treatment of nonthrombocytopenic purpura

Most cases disappear on their own without treatment, but when serious complications(for example, renal function) patients are treated in a hospital. For elimination joint pain An anesthetic is prescribed, and corticosteroids are also indicated. If the kidneys are damaged, it is necessary to correct the level of electrolytes in the blood.

Allergic vasculitis

Vasculitis is inflammation of blood vessels. It can cause blood vessel damage, thickening, scarring, and weakening of vessel cell membranes. There are many various types vasculitis; some of them are acute and do not last long, while others may be chronic in nature. Allergic vasculitis is acute form diseases.

There is inflammation and redness of the skin that occurs when it comes into contact with any external stimulus. Red spots appear on the skin, which some doctors simply call purpura. These spots seem to be raised above the surface of the skin, but they can also be flat. Their color ranges from red to purple.

Other common symptoms: joint pain, enlargement lymph nodes, kidney inflammation.

The causes of allergic vasculitis may be:

• infections;
• chemical substances;
• food allergens;
• potent medications;
• any substance or material.

Most often, vasculitis is caused by the body’s interaction with medicines, but it can also appear in combination with certain infections or viruses. In some cases, the exact cause of such a reaction cannot be identified.

Hypersensitivity in vasculitis is usually caused by a reaction to medications. The most common drugs that can trigger the disease are:

• penicillin;
• sulfonamides (a class of antibiotics);
• some medications for high blood pressure;
• phenytoin.

Allergic vasculitis can also be caused by chronic bacterial infections and viruses such as HIV or hepatitis B and C. People with an autoimmune disorder called lupus may also suffer from itchy red patches on the skin. If the cause of the disease is in interaction with medicines, symptoms appear within 7-10 days after starting treatment. Some patients may show the first symptoms as early as two to three days after starting medication.

The main treatment is to relieve symptoms such as itching and burning. Usually allergic vasculitis goes away on its own in a couple of weeks. To alleviate the condition of patients, antiallergic drugs are used that reduce inflammation and itching, as well as corticosteroids, aspirin, and herbal medicines.

© 2015 DermNet New Zealand Trust

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© 2015 Regents of the University of Minnesota.

© 2015 Johns Hopkins Vasculitis Center

National Institutes of Health, Department of Health and Human Services

©MedicineNet, Inc.

• Blood clotting disorders. Consumptive coagulopathy (DIC syndrome). Fibrinolytic bleeding. Purpura: fibrinolytic and fulminant - what is consumption coagulopathy, causes, symptoms, treatment of DIC syndrome. Causes and treatment of fibrinolytic bleeding. What is purpura - types, symptoms of purpura, prevention measures
• Hereditary hemorrhagic thrombasthenia (Glanzmann's thrombasthenia). Thrombocytopathy. Senile purpura (senile) - Hereditary hemorrhagic thrombasthenia (Glanzmann's thrombasthenia). Thrombocytopathy. Purpura senile (senile)
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Thrombocytopenic purpura in children and adults photo

Skin diseases affect children and adults with equal frequency. One of these diseases is thrombocytopenic purpura. Photos will be discussed in the article. The disease is due to its complex nature and special course. Let's look at how this process occurs in children, how often it occurs in adults, and what treatment methods are considered the most effective for eliminating the disease.

What is thrombocytopenic purpura?

Thrombocytopenic purpura, photos of which are presented below, is one of the types of hemorrhagic phenomenon - diathesis. The disease is characterized by a deficiency of red blood platelets - platelets, which is often caused by the influence of immune mechanisms. Signs of the disease include random effusions of blood into the skin, and they can be multiple or single. The disease is also accompanied by an increase in uterine, nasal and other blood flows. If progression is suspected of this disease, the task is to evaluate clinical data and other diagnostic information - ELISA, tests, smears and punctures.

This one is benign pathological disease is accompanied by the fact that there is a deficiency of platelets in the blood, and there is a tendency to increased bleeding and the development of hemorrhagic sign. In the presence of a disease in the peripheral blood system, a downward change in the level of blood platelets is observed. Among all hemorrhagic types diathesis, purpura occurs most often, mainly in preschool children age factor. In adults and adolescents, the pathological syndrome is less common and affects mainly women.

According to the course, the disease can be divided into acute and chronic forms. In the first case, the disease occurs in childhood and lasts six months, while platelets are normalized and there are no relapses. In the second situation, the duration of the disease exceeds a period of 6 months and progresses in adults. The recurrent form has a cyclical course, with repeating functions of individual episodes.

Causes of the disease

In 45% of situations, the disease develops spontaneously. In 40% of cases, the development of this pathology is preceded by numerous viral and bacterial infectious phenomena that were experienced a couple of weeks before the onset. Typically, these factors include several diseases.

Often the manifestation of the disease occurs as part of active or passive immunization. Several more factors that provoke the formation of the disease are taking medications, x-ray irradiation, exposure to chemicals, surgical interventions, insolation.

Symptoms of thrombocytopenic purpura

The onset of any disease and manifestation is particularly acute. Sudden Appearance hemorrhages aggravates the situation and creates a characteristic of the disease appearance cover. Against the background of primary symptoms, additional signs– nosebleeds, worsening general condition, pale skin, sharp increase bodily temperature regime. If this acute process, full recovery without relapse usually occurs after 1 month. As the disease manifests itself, many children experience a noticeable enlargement of the lymph nodes. By cause of lung In about 50% of children, the disease cannot be diagnosed.

If we are talking about chronic form illness, acute onset is not expected. The first symptoms appear long before acute symptoms begin. Bleeding occurs in the area skin and looks like pinpoint hemorrhages. They aggravate the overall picture when the disease worsens. In first place among the formations is skin purpura - a rash in a child or adult. Hemorrhagic manifestations usually appear abruptly, mainly at night.

In rare situations, the symptom can be “ bloody tears", which is due heavy bleeding from the eye area. This phenomenon is usually observed together with skin formations. Blood is flowing persistently and abundantly, against the background of this phenomenon anemia may occur. Gastrointestinal bleeding are less common, but in girls the process may be accompanied uterine pathologies and secretions. Rarely, purpura may cause hematomas and prolonged bleeding. Children suffering from the disease usually have no complaints, except that a couple of signs can be identified.

• General state of lethargy and apathy;
• increased fatigue;
• normal body temperature;
• normal size of the spleen and liver;
• sharp and severe irritability.

Chronic forms of the disease usually occur in children after 7 years of age. The course is wavy, with remissions and exacerbations alternating.

Thrombocytopenic purpura in children photo

Thrombocytopenic purpura, photos of which are presented in the article, has several forms and manifestations. The main signs of its presence in young children are hemorrhages and effusions into the mucous membranes and under the skin. The color of hemorrhages varies from red to green, and the size of the rash on the face and body ranges from small petechiae to large blisters and spots.

The manifestation is characterized by a lack of symmetry and logic of the sequence of formation. In children, the formations do not hurt or bother. When the stage of clinical remission occurs, the disease disappears and disappears completely.

Cutaneous hemorrhagic syndrome has several specific and characteristic features manifestations.

• The severity of the hemorrhagic symptom does not correspond to the traumatic impact. Formations can appear suddenly and unexpectedly.
• During the course of a childhood illness, polymorphism is observed, in which the variety and size of the rashes are different and multifaceted.
• Skin hemorrhage does not have favorite places localization. For example, a rash may appear on the arms, body, face, rash on the legs and other parts of the body.

Most dangerous manifestation childhood illness is the appearance of hemorrhage in the sclera, which can give rise to the most severe complication– cerebral hemorrhage. The outcome of this course depends on the form and location of the pathology, as well as on the accepted therapeutic measures. Speaking about the prevalence of the disease, it can be noted that its frequency ranges from 10 to 125 cases per million population over an annual period.

Thrombocytopenic purpura in children treatment

Before you appoint effective techniques treatment, a study of the disease is carried out - a detailed diagnosis. There may be a decrease in the number of platelets in the blood and longest time bleeding. There is not always a correspondence between the duration this phenomenon and the degree of thrombocytopenia. Secondary indicators of the presence of the disease are altered properties of the blood, changes in hormones in it, as well as other substances.

Differential diagnosis

The disease must be differentiated from a number of other manifestations that are similar in their signs and symptomatic indicators.

• Acute leukemia – in in this case Metaplasia appears in the bone marrow area.
• SLE – to make a detailed diagnosis, it is necessary to take into account information from an immunological study.
• Thrombocytopathy involves a change in the content and level of platelets in the other direction.

Therapeutic activities for children

Thrombocytopenic purpura, photos of which are presented in the article, suggests no treatment if the forms of the disease are not severe. At moderate severity currents are shown therapeutic interventions, if there increased risk bleeding. Such phenomena are mainly characteristic of peptic ulcers, hypertension, duodenum. If the platelet level in the test reaches<20-30×10^9/л, то терапия назначается в стационарных условиях. Если больной человек страдает от хронической формы проявления заболевания, для которой характерны обильные течения крови и попадание жидкости в жизненно важные элементы, проводится спленэктомия. Ребенок во время геморрагического криза должен проводить время в постели.

1. If the therapy is pathogenetic in nature, glucocorticosteroids are prescribed at a dose of 2 mg/kg body weight per day orally, and immunosuppressants are used (cyclophosphamide, vincristine, if other methods are ineffective). All medications are specifically prescribed by a doctor.
2. To eliminate the symptoms and features of the disease, human Ig is used, and the child is given a dosage of 1 g per kg of weight for two days.
3. Danazol, which has an androgenic effect, is often used, as well as drugs from the interferon group - ROFERON-A, REAFERON, ANTI-A.
4. Drugs of the symptomatic group – aminocaproic acid, etamsylate.

Forecasting factors

In most situations, the prognosis is favorable. In children, full recovery occurs in 90% of cases, in adults – in 75%. During the acute stage of the process, noticeable complications may arise in the form of a hemorrhagic stroke, and there is a high risk of death. When carrying out treatment, it is necessary that the sick person is constantly under the supervision of a hematologist, and it is important to exclude from the treatment diet drugs that affect the properties of platelet aggregation. These medications include caffeine, aspirin, and barbiturates.

Thrombocytopenic purpura in adults photo

A rash in adults, along with other symptoms, also occurs. The clinical picture is similar to the manifestations of the disease in children. Spots and formations on the skin do not bother a person. The only caveat is that thrombocytopenic purpura (photo can be seen in the article) among the adult population is 2-3 times more likely to affect the fair sex.

Thrombocytopenic purpura in adults treatment

The treatment complex for children and adults has many similarities, and all therapeutic methods are determined by how severe the disease is and how long it should last. Treatment consists of conservative therapy, which involves taking medications, as well as the use of surgical methods. Regardless of the manifestation of the disease, bed rest is an important part of recovery.

Drug treatment

Previously, remedies for treating the disease in children were described; in principle, they are all suitable for adults, but to simplify the situation and improve the condition, it is recommended to include in the diet hormonal drugs that help reduce vascular permeability and increase blood clotting. If there is multiple rashes on the body, as well as other symptoms, the use of several groups of remedies is effective.

1. PREDNISOONE is used at a dose of 2 mg per kg of body weight per day, subsequently the dosage is reduced. Usually this therapy gives a tremendous effect; patients relapse after stopping hormones.
2. If measures taken in adults do not produce results, immunosuppressants are used. This is imuran, 2-3 mg per kg of body weight per day. Duration of therapy is up to 5 months. Also vincristine 1-2 mg once a week.

The effect of such treatment can be detected after just a few weeks; over time, the dosage is reduced. Patients should also consume a vitamin complex, especially groups P and C. Such measures will make noticeable improvements in the properties of platelets. In addition, doctors prescribe calcium salts, aminocaproic acids, ATP, magnesium sulfate. Collections of natural folk remedies (nettle, rose hips, pepper, St. John's wort) are effective.

If conservative methods of therapy are not particularly effective, it comes to resorting to surgical removal of the spleen. Cytostatic agents are often prescribed to help reduce the number of harmful cells. But these drugs are used exclusively in rare cases (IMURAN, VINCRISTINE, CYCLOPHOSPHAN).

Diet for thrombocytopenic purpura

The main requirement that implies the possibility of quickly getting rid of the disease is adherence to a special diet. The patient's diet should be moderately high in calories and complete. Food is served chilled, it should be liquid and contain small portions. The rash, a photo of which was presented in the article, can quickly disappear if you eat the right foods.

Foods to reduce platelets

There is no specific treatment menu, but the main rule is to get nutritious food with proteins and essential vitamins. The benefit lies in the use of several product groups.

• Buckwheat porridge;
• peanuts and other nuts;
• fruits and juices from them;
• any vegetables;
• corn;
• beef liver;
• cereals;
• wheat and products made from it.

What to exclude from your diet

• spicy and salty foods;
• high fat foods;
• food with impurities and aromatic additives;
• hot spices and sauces;
• restaurant food and fast food products.

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Thrombocytopenic purpura is a decrease in the number of platelets, usually of immune origin. It is characterized by the appearance of hemorrhages on the skin, external and internal bleeding. Read more about its symptoms, types and treatment methods in this article.

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Causes of thrombocytopenic purpura development

The disease is quite common and ranks first among the causes of increased bleeding. It manifests itself in early childhood and the preschool period; among adult patients it is more common in women. In half of the cases, the cause of the pathology cannot be determined.

In every third patient, thrombocytopenic purpura occurs after an infection. Typically, the first signs appear 15 to 20 days after the acute manifestations of viral or bacterial diseases have subsided.

The provoking factor may be:

• influenza, adenoviral infection;
• chicken pox, measles, rubella, whooping cough;
• malaria;
• parotitis;
• septic endocarditis;
• administration of vaccines and serums;
• taking hormonal medications;
• radiation therapy;
• major surgery;
• multiple trauma;
• prolonged exposure to the open sun, in a solarium.

Familial forms of the disease have been identified. But most cases are associated with the appearance of antibodies in the blood against one’s own platelets. They attach to their membrane and destroy it. As a result, cells die not in 1 - 2 weeks, as is normal, but in 5 - 12 hours.

Antibodies can also enter the body through blood transfusion, platelet transfusion, or from mother to fetus during the prenatal period. The qualitative composition of cell membranes changes under the influence of viruses, medications or against the background of systemic autoimmune diseases (lupus, hemolytic anemia).

A lack of platelets also occurs when their formation is impaired due to aplastic anemia, vitamin B12 deficiency, leukemia, bone marrow diseases, including tumor metastases.

Symptoms in adults and children

Manifestations of the disease are associated with impaired formation of blood clots, as well as increased capillary permeability and insufficient contraction. As a result of this, bleeding does not stop for a long time, since blood clots do not cover the site of tissue damage.

The first symptoms of thrombocytopenic purpura appear when the platelet count drops from 150 million/l to 50 or below. During an exacerbation of the disease, only single blood platelets are found in the blood.

Bleeding occurs, and small spots – “bruises” – become noticeable on the skin. Their number gradually increases - from small dotted rashes to large spots, and the color changes from bright purple with blue to light yellow-green. Typical localization is the front surface of the body, legs and arms, rarely the rash covers the skin of the face and neck. The location is asymmetrical, the elements of the rash are painless.

The same hemorrhages can be found on:

• tonsils, palatine part of the mouth;
• conjunctival and retinal membranes of the eyes (a dangerous sign, since it is often followed by bleeding in the brain);
• eardrum;
• functioning tissue of internal organs;
• vascular layers of the brain.

A characteristic sign of the pathology is sudden (often at night) bleeding with minor damage to the skin. Intense hemorrhages can occur from the nose, gums, after minor surgical or diagnostic procedures.

Women usually have difficult periods and are accompanied by severe blood loss. Before the onset of menstruation, a skin rash and nosebleeds often appear. During the period of ovulation, there are hemorrhages in the abdominal cavity, simulating an ectopic pregnancy.

Also, the appearance of blood is detected in sputum, vomit and intestinal masses, and urine. The temperature is often normal, tachycardia and a weak first tone are common (a consequence of anemia). The spleen is often of normal size or slightly enlarged.

In children under two years of age, a special form of the disease is diagnosed - infantile thrombocytopenic purpura. It begins acutely, with a pronounced rash on the body and mucous membranes, and the number of platelets in the blood sharply decreases.

As it progresses, it may occur. Its onset is evidenced by:

• dizziness,
• headache,
• vomit,
• convulsive syndrome,
• limb paralysis,
• disturbance of consciousness.

Types of thrombocytopenic purpura

Depending on the causes of occurrence and variants of the course of the disease, several clinical manifestations of the disease are distinguished.

Idiopathic (Werlhof's disease)

Although the exact cause of this form of the disease has not been established, its immune origin is beyond doubt. When examining blood, antibodies against platelets are found, as well as lymphocytes that are sensitive to the antigenic composition of the membranes of blood platelets.

The trigger point is a change in the activity of macrophages (eater cells) of the spleen, which perceive their platelets as foreign.

Hemorrhagic

Bleeding and hemorrhagic rash are the main symptoms of thrombocytopenic purpura. Therefore, this variant of the course of the disease is considered classic. In addition to it, there is also thrombotic purpura with an acute onset and severe renal failure. With it, hyaline blood clots form in small vessels, disrupting blood microcirculation.

Hemorrhagic syndrome can worsen in the form of a crisis of increased bleeding and a sharp drop in platelets. In the remission stage, bleeding time decreases, but laboratory signs remain, or complete normalization of the condition and hematological parameters occurs.

Acute

Happens more often in childhood. Symptoms persist for six months and then disappear after the number of platelets in the blood is restored. Chronic forms are usually diagnosed in adult patients; signs of the disease tend to recur after a period of remission.

Immune

The main symptom is the formation of antibodies to the platelet membrane. If its properties have changed under the influence of viruses, bacteria or medications, then this form (heteroimmune) has a fairly favorable course. After cleansing the body, the cells restore their composition, and the formation of antibodies stops. It is more often acute and is diagnosed mainly in childhood.

Autoimmune, usually idiopathic. That is, the reason for the appearance of antibodies to one's own cells cannot be established. It has a relapsing (repeating) course, the severity depends on the state of the immune system. It can occur secondarily, against the background of an existing systemic connective tissue disease (lupus, thyroiditis, scleroderma).

Isoimmune thrombocytopenic purpura is associated with the supply of antibodies from the outside - with blood transfused or to the fetus from the mother through the placenta.

Watch the video about the causes and treatment of thrombocytopenic purpura:

Diagnosis of the disease

Clinical features of thrombocytopenic purpura are similar to bone marrow lesions, leukemia, vasculitis, disorders and thrombocytopathies. In order to make a correct diagnosis, it is necessary to conduct a hematological examination. Characteristic signs of thrombocytopenic purpura are:

• decrease in platelets in the blood;
• prolongation of bleeding time (does not always reflect the severity, since it is also influenced by the properties of the cells);
• increase in activated partial thromboplastin time;
• the blood clot does not contract, or the degree of its retraction (contraction) is significantly reduced;
• decreased concentration of serotonin in the blood;
• leukocytes are normal, with bleeding anemia occurs;
• bone marrow puncture reveals normal hematopoiesis;
• the appearance of antiplatelet antibodies.

During a hemorrhagic crisis, increased fragility of blood vessels is detected - when struck with a hammer (test of tendon reflexes), a cuff is applied to measure pressure, a needle prick, or a pinch test, a characteristic spotted hemorrhagic rash appears.

For differential diagnosis, bone marrow puncture, immunological blood tests and studies of the properties and structure of platelets are used.

Treatment of thrombocytopenic purpura

• restriction of intense physical activity, schoolchildren are exempted from physical education classes or transferred to a special group;
• avoid prolonged exposure to the open sun, hypothermia;
• choose a warm or cool food temperature that does not injure the mucous membranes of the mouth, caffeine-containing drinks are prohibited;
• Before routine vaccinations, consultation with a hematologist is required.

Before taking any medications, you need to make sure that they do not affect blood clotting. Many painkillers and anti-inflammatory drugs (aspirin, paracetamol, naproxen, indomethacin, ibuprofen), sulfonamides, furosemide, heparin, beta blockers, dipyridamole, penicillin and cephalosporin antibiotics, nitrofurans, barbiturates are contraindicated.

Indications for the use of medications for the treatment of thrombocytopenic purpura are a decrease in platelets to 30 - 45 million/l and the presence of peptic ulcer, which can increase the risk of bleeding.

If the level of red platelets drops below 30 million/l, urgent hospitalization is indicated.

In therapy they use:

• Hemostatic agents - Tranexam, Aminocaproic acid, Etamsylate orally or intravenously. For local hemostasis, a hemostatic sponge, fibrin or gelatin films, tampons with adrenaline, and hydrogen peroxide are used.
• Hormonal drugs - Prednisolone for 2 weeks with a dose reduction or courses of 7 days with a five-day break. In case of hemorrhagic crisis, pulse therapy is prescribed - intravenous administration of high doses of Metipred.
• Normal human immunoglobulin in combination with hormones or for independent use.
• Interferons (Roferon, Intron).
• Danazol.

Platelet mass is not used, as it can worsen the condition, provoke an exacerbation of autoimmune cell destruction and a hemorrhagic crisis. Washed red blood cells are recommended only for severe anemia after bleeding, which cannot be corrected with other antianemic drugs.

If the hormones are insufficiently effective, sometimes cytostatics are added to therapy or, under their cover, the dose of Prednisolone is gradually reduced. But most often, severe forms that recur when hormones are withdrawn are an indication for splenectomy - removal of the spleen. This organ is involved in the destruction of platelets and after surgery the number of cells increases.

In children, this method of treatment is prescribed from the age of 5 and in 80% of cases leads to a complete restoration of blood counts.

Patients are under constant supervision of a hematologist. During the period of deterioration of the condition, weekly blood tests are indicated; when remission occurs, they are performed at least once a month, as well as after any previous illness.

Thrombocytopenic purpura is a disease associated with a decrease in platelets in the blood. Occurs due to immunological disorders; it is provoked by viruses, medications, and blood transfusions. It can be congenital when antibodies from the mother penetrate into the fetus.

It manifests itself as a hemorrhagic dotted and spotty rash, bleeding from the mucous membranes. To make a diagnosis, a complete hematological examination is necessary. Treatment is carried out with hemostatic, hormonal drugs, and the introduction of immunoglobulins. If medications are ineffective, splenectomy is prescribed.

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Often, a person may develop spots on the surface of the skin, but it is rare that someone can attribute such manifestations to a violation of the composition of the blood. This disease is called thrombocytopenic purpura and is endowed with certain characteristics.

Causes of pathology

Thrombocytopenic purpura, or as it is also called, Werlhof's disease, is a disease directly related to changes in the quantitative presence of platelets in the blood. Often these components can stick together, which also leads to a decrease in their number. This disease process entails the occurrence of numerous hemorrhages, which can form not only on the upper layer of the epidermis, but also on the mucous membranes.

If we talk about the factors influencing the occurrence and development of pathology, the exact cause of the disease has not yet been identified, however, in some cases it may be influenced by a hereditary factor. Additional and less common causes of the disease include:

• negative change in the performance of the circulatory system;
• tumor growths in the brain area;
• exposure to the external environment with a high content of radioactive substances;
• the presence of a bacterial or viral infection in the body.

Some medical experts argue that the appearance of such changes (Werlhof's disease) may be influenced by the use of certain contraceptive drugs, as well as the use of chemotherapy to combat cancer. This disease most often occurs in childhood; in more mature patients, the pathology can be detected mainly in representatives of the weaker half of humanity.

Symptomatic signs that appear

As mentioned earlier, the symptomatic signs of this disease begin to manifest themselves immediately after the level of platelets in the blood begins to noticeably decrease. The main visible symptom of the pathology is the appearance of rashes on the skin and mucous membranes. They can be of different depths and sizes, while the pain of their manifestation can also be different with thrombocytopenic purpura, the symptoms of which can have not only the nature of the rash.

The rashes of this disease may vary according to certain characteristics:

Bleeding can often be a symptom of the disease. The form in this case can be as varied as its intensity. The main forms of the disease include:

• nasal;
• gum;
• in combination with sputum when coughing;
• in urine or vomit;
• during bowel movements.

It is important to consider other possible symptoms of thrombocytopenic purpura. Hemorrhages can also occur in the internal organs, but such manifestations of the disease are much more serious and have the character of pronounced pain. There is no change in body temperature with such deviations; in some cases, a rapid heartbeat may occur. In childhood, upon examination of the patient, enlarged lymph nodes are revealed, accompanied by pain. With Werlhof's disease, symptoms can only be expressed in relation to laboratory manifestations.

Features of the course of the disease

The course of the disease directly depends on what caused it. If the formation of pathology was influenced by the influence of drugs, then this form of the disease does not require the use of drugs and can resolve itself in a maximum of a few months. When exposed to radiation, the patient experiences a more severe form of the disease, and the patient’s general condition is characterized as severe. In childhood, Werlhof's disease occurs instantly and is relatively severe. Its transition to a chronic form with a minimal presence of platelets in the blood cannot be ruled out.

Thrombocytopenia has several stages:

• hemorrhagic crisis - symptomatic signs are clearly expressed, when studying the blood, a reduced number of platelets present is observed;
• clinical remission - symptoms can be eliminated, but clinical pathological processes occur;
• clinical-hematological remission - characterized by the restoration of all abnormal indicators.

At certain stages of the course of Werlhof's disease, patients may experience a feverish state, the manifestation of convulsions in the lower extremities; in a more complex form, the spread of cerebral coma, the presence of pain in the lower abdomen, as well as the presence of pain in the joints are possible.

Methods of diagnosis and treatment

In order for the attending physician to accurately establish a diagnosis, he needs to take into account all the symptomatic signs and factors that provoke the development of pathology. In this case, when conducting a survey, you should pay attention to the time period regarding the external influence of factors, the manifestation of the disease on the part of the patient’s relatives, as well as the possible presence of bleeding, both external and internal organs.

After this, a series of necessary laboratory tests are carried out, based on the results of which a diagnosis is made by a hematologist.

How thrombocytopenia will be eliminated is determined depending on how severe and painful the Werlhof pathological process itself is, the treatment of which has several options. Depending on this, either the traditional method of treating the disease with drugs or through surgery is used. Whatever the form of the pathology and the nature of its manifestation, the process of treating the disease is carried out only within the hospital with mandatory adherence to bed rest. Nutrition deserves special attention, since it is extremely necessary to follow a diet during this disease; the diet should be complete and moderate in calories. Portions should be small, preferably in liquid form.

As for the use of medications when diagnosing Werlhof’s disease, hormonal medications deserve special attention. They help improve the process of blood clotting and are used, as a rule, for extensive damage to the skin during this disease. The most popular is Prednisolone, which is initially taken in large dosages. The effectiveness of treating the disease is noticed after the first two weeks of treatment, after which the volume of the drug is reduced. In the future, the patient needs to take special vitamin complexes, and to stop bleeding and prevent it, it is suitable to take medicinal preparations, which include nettle, rose hips and yarrow.

In certain situations, specialists have to resort to a form of treatment for the disease such as blood transfusion. This is extremely necessary when diagnosing a severe form of the disease or to stop active and extensive bleeding. If the above methods are ineffective in relation to the diagnosed disease, then the patient is prescribed surgical removal of the spleen.

This disease does not exclude the occurrence of serious complications, the main of which is considered to be a stroke or hemorrhage in the brain area. This process occurs instantly, disrupting consciousness, provoking the development of headaches, vomiting and numerous neurological disorders. In the case of major bleeding, it is possible to subsequently diagnose the patient with anemia, and in the case of chronic bleeding, a disease such as iron deficiency anemia.

Very rarely, when purpura disease can be fatal, as a rule, positive dynamics and complete recovery of the patient are observed. All possible concerns arise only in the acute form of the disease.

It is important to remember about preventive measures regarding this disease. In this case, it is recommended to monitor your diet so that your diet includes only those foods that have minimal allergenic properties. It is important to consider the effects of medications taken. Patients should monitor the effect of sunlight and especially ultraviolet radiation on the existing disease.

It is especially important to avoid contact with infectious patients.

As for pediatric patients, in this case it is important to regularly show the child to medical specialists for timely examination and possible detection of the disease. The child should be taught a healthy lifestyle, mainly exercise and physical activity. It is especially important to monitor the child’s feeding process, even if the disease has not yet been diagnosed.

Thus, a disease such as thrombocytopenic purpura in adults is a serious and problematic process. It requires mandatory treatment and timely diagnosis, since in the initial stages of its development the possibility of bleeding, especially related to internal organs, is reduced. To date, the disease has not been fully studied, but medical experts offer several options for its elimination and prevention, among other things.

In contact with

4. You are not taking medications that can cause thrombocytopenia.

Treatment of purpura is primarily aimed at correcting the hemorrhagic syndrome, and only then at increasing the number of platelets in the blood. This is due to the fact that patients in most cases are resistant to low platelet counts, but the side effects of therapy can be more serious than the consequences of purpura.

Idiopathic thrombocytopenic purpura occurs with equal frequency in boys and girls before the age of 10, and in adults after 10 years, and many times more often in women than in men.

Purpura most often appears in spring and autumn.

In 10% of cases, death is possible, associated not with purpura as a disease, but with its consequence - hemorrhage in the brain. This is due to the fact that patients delay the period of contacting specialists.

Immediately before the operation, the patient is vaccinated in order to prevent possible inflammatory processes after removal of the spleen.

Thrombocytopenic purpura: risk factors, types, development, diagnosis, therapy, prognosis

Thrombocytopenic purpura refers to hemorrhagic diathesis that occurs with a violation of the platelet component of hemostasis, where the number of blood platelets falls below the acceptable level (150 x 10 9 / l). This phenomenon occurs under circumstances that cause platelets to become overly destroyed, overconsumed, or underproliferate in the bone marrow.

Most often, thrombocytopenia (TP) occurs with increased cell destruction, although all these processes are also not excluded in one patient, they are combined with each other, run in parallel and, naturally, aggravate the situation. The platelet count in such cases drops to critical levels, which in turn determines the severity of the disease.

Prerequisites for the occurrence of thrombocytopenia

Most thrombocytopenia, as has already been proven, is acquired in nature, that is, genetically programmed defects are not the basis of the disease, although isolated cases of hereditary pathology still sometimes occur:

1. Impaired synthesis of thrombocytopoietins in the human body is associated with hereditary thrombocytopenia;
2. The deficiency of enzymes that carry out glycolysis or the Krebs cycle is also a genetic abnormality.

All other conditions characterized by a decrease in the platelet level are divided into immune and non-immune, which have their own specific causes.

Non-immune thrombocytopenia

The starting factors for the occurrence of non-immune thrombocytopenia are:

• Mechanical effects on platelets, causing their injury (vascular prosthetics, splenomegaly, giant hemangiomas);
• Tumors with metastases to the bone marrow;
• Impaired hematopoiesis, accompanied by sluggish cell proliferation, which is characteristic of aplastic anemia, which is often accompanied by a decrease in hemoglobin;
• Exposure to radiation or chemicals that damage myelopoiesis;
• High need for platelets with a lack of folic acid or Vit B 12, disseminated platelet aggregation - DAT, RDS - respiratory distress syndrome, thrombosis, disseminated intravascular coagulation syndrome, long-term therapy with low doses of heparin).

Thrombotic thrombocytopenic purpura (TTP), which has an acute onset and is distinguished by a malignant course, is also classified as a non-immune variant of TP. The etiology of this disease is still unclear, but it is known that it is usually fatal. It has been noted that TTP occurs more often in adults in the following cases:

1. Previous bacterial or viral infection;
2. Vaccinations;
3. Presence of HIV infection;
4. Pregnancy;
5. Use of oral contraceptives;
6. Treatment with certain anticancer drugs;
7. Collagenoses;
8. As a hereditary pathology (very rare).

Thrombotic thrombocytopenic purpura is characterized by the deposition of hyaline platelet thrombi, the formation of which is caused by spontaneous aggregation of platelets in small-caliber vessels, as a result of which they close the vessel. Platelet blood clots invade the entire human body and damage the microvessels of many organs, so TTP is characterized by the presence of symptoms:

• Hemolytic anemia;
• Fever;
• Neurological symptoms;
• Acute renal failure.

The death of the patient usually occurs as a result of kidney failure (RF).

Production of antiplatelet antibodies is a path to immune thrombocytopenia

Immune thrombocytopenic purpura has several types:

1. Isoimmune(alloimmune) thrombocytopenia, which often occurs during intrauterine development. This occurs if antiplatelet antibodies are transported to the child from the mother (a decrease in platelets is observed in the baby in the first month of life), or antiplatelet antibodies appear as a result of a blood transfusion. And due to the fact that platelet antibodies are non-circulating, they immediately stick to platelet antigens.
2. Heteroimmune(haptenic) thrombocytopenia is formed by the formation of antibodies, which are produced as a response to the altered antigenic structure of platelets (platelet antigens change and they become “foreign” to one’s own immune system), which sometimes happens after a history of respiratory viral diseases or after taking certain medications. Thrombocytopenia associated with viruses and drugs can be observed for up to six months, but if it does not disappear during this period of time, then it is renamed and considered autoimmune.
3. Autoimmune Thrombocytopenia (AITP) includes the largest number of forms, which include the so-called idiopathic thrombocytopenic purpura, the cause of which is unknown. The idiopathic form of any origin was previously called Werlhof's disease, which does not apply to the immune form. Werlhof's disease is now called only thrombotic thrombocytopenic purpura, which is also idiopathic, but non-immune in nature.

Autoimmune thrombocytopenia also has its own division depending on the direction of antibodies and the cause of its occurrence. Autoimmune thrombocytolysis is called idiopathic when the cause of aggression against one’s own cells is not established, symptomatic if it is possible to establish why the blood platelets suddenly begin to collapse. Symptomatic thrombocytopenic purpura is often a companion to chronic pathological conditions:

Hemorrhagic diathesis in AITP

• Chronic forms of leukemia (usually chronic lymphocytic leukemia);
• Inflammatory diseases of the liver and kidneys;

With AITP, the immune system suddenly begins not to recognize its own platelet, which is completely normal in all respects, and, mistaking it for a “stranger,” responds by producing antibodies against it.

Immune thrombocytopenic purpura occurs at any age, starting from the neonatal period, so it is far from uncommon in children. The disease primarily affects females. The course of the pathological process often takes on a chronic relapsing form, especially for idiopathic thrombocytopenic purpura, since existing hypotheses of its occurrence do not explain the true cause of the disease.

Development of purpura

The development of thrombocytopenic purpura largely depends on thrombocytolysis (cell death under the influence of antibodies). In the bone marrow, megakaryocytes begin to be actively produced, which are quickly consumed and increase the number of platelets entering the bloodstream, where the blood platelets die within a short time. Instead of their allotted week of life, they exist for several hours, thereby forcing the bone marrow to work intensively and replenish losses. Such thrombocytopenias are called hyperregenerative, which mainly occur in children and make up the majority of clinical forms in pediatrics. But it happens that antibodies, in addition to platelets, are also directed at megakaryocytes, which devastates the sprout and prevents blood platelets from forming. This is the so-called hyporegenerative thrombocytopenia, which is not necessarily immune.

A large role in the pathogenesis of TP is given to the functional characteristics of platelets, their participation in hemostasis and nutrition of the vascular wall, as well as adhesive-aggregation ability, because they are able to stick to each other and to the damaged endothelium with the formation of a platelet plug.

We can conclude that the main factor triggering bleeding is thrombocytopenia. When the vascular walls stop receiving platelet feeding, their degeneration occurs, which cannot prevent the passage of red blood cells through the vessels. The slightest injury in such cases can cause prolonged bleeding.

Diagnostics

A diagnosis of thrombocytopenic purpura can be suspected if there are frequent nosebleeds and a hemorrhagic petechial-spotted rash, which differs from an allergic rash in that it does not disappear with pressure. A low platelet count in a blood test confirms the diagnosis of TP.

When diagnosing TP in a hemostasiogram, you can get an increase in Duke bleeding time to 30 minutes or more and a decrease (less than 60%) in blood clot retraction, while Lee White coagulation will remain normal. Thrombocytopenic purpura is differentiated from hereditary thrombocytopathy (thrombocytopenia) using family history. Hereditary thrombocytopathy is characterized by a shortening of the life of blood platelets due to defective membranes or a lack of enzymes in the cells themselves.

Hemorrhagic rash means purpura

Thrombocytopenic purpura is characterized by the appearance of a petechial-spotted type of bleeding. And in case of major injuries, ecchymatoses can be observed. Thus, the symptoms of thrombocytopenic purpura can be presented as follows:

1. Hemorrhages that appeared at injection sites;
2. Severe bleeding from the mucous membranes (oral cavity, tonsils, pharynx);
3. Infection one to two weeks before the rash appears;
4. Body temperature is normal even in children and, with only rare exceptions, it can rise to low-grade fever;
5. Single or multiple spontaneous hemorrhages (sometimes after minor trauma);
6. Asymmetrical skin lesions, petechiae and “bruises” of different sizes;
7. Hemorrhages vary in color: from purple (bright red) to blue-green and yellow;
8. Bruises resolve within 3 weeks;
9. Inconsistency of injury and hemorrhage;
10. The appearance of hemorrhages at night (during sleep);
11. The appearance of a hemorrhagic rash on the legs, arms and torso;
12. Bleeding from the nose, gums and natural cavities;
13. Gastrointestinal bleeding (black stool or red blood);
14. Bloody vomiting, which is secondary in nature, as it occurs as a result of swallowing blood from the nose;
15. Anemia that develops due to constant blood loss;
16. Hemorrhages in the brain are possible, which is a very dangerous symptom.

In addition, bleeding from the ears, hemoptysis and hemorrhage into the vitreous body of the eye, which led to complete blindness, were described in medical practice.

Manifestations of thrombocytopenic purpura

People often confuse thrombocytopenic purpura with Henoch-Schönlein purpura, which is characterized by a vasculitic purpuric type of rash, which is why the disease is called hemorrhagic vasculitis. What is confusing is that the rash is similar to the petechial macular rash seen in TP. Henoch-Schönlein disease can be described as follows:

• A bright red papular rash that fades over time and leaves bluish pigment spots;
• Itching sensation before the rash;
• Body temperature often rises;
• The rashes are located symmetrically on the legs and arms;
• Damage to the vessels of the kidneys (micro- and macrohematuria).

The rash in the case of hemorrhagic vasculitis is very similar to an allergic one, but it does not disappear with pressure. Henoch-Schönlein disease has a chronic course, where, in addition to the skin, joints, gastrointestinal tract, and mucous membranes can be affected, therefore there are 4 forms of this disease:

How to treat thrombocytopenic purpura?

If thrombocytopenic purpura is suspected, the patient should be hospitalized, because strict bed rest with such a disease is required until platelets are restored to the minimum physiological level.

If there is bleeding, the first step is to use local (ε-aminocaproic acid, hemostatic sponge, thrombin, adroxon) and general (ascorutin and calcium chloride for intravenous administration) hemostatic agents. At the first stage of treatment, corticosteroid therapy is included, which lasts up to 3 months.

There is not much interest in treating thrombocytopenic purpura by transfusion of platelet mass, due to the fact that the donor's platelets must still take root in the recipient, and not immunize him even more (individual selection is indicated), therefore, in case of severe anemia that has arisen against the background of blood loss, preference is given to washed red blood cells.

Splenectomy (radical method) is performed at the second stage of treatment in cases of persistent bleeding, aseptic inflammation or threat of splenic rupture. However, if removal of the spleen also does not have an effect, then treatment is continued with small doses of corticosteroids. Although they will not restore the platelet count, they will at least reduce the risk of bleeding in the brain.

For such patients, barbiturates, caffeine, aspirin and other drugs that help reduce the platelet component in the blood are absolutely contraindicated, so the patient is strictly warned about this.

After completing the course of treatment and being discharged from the hospital, the patient is registered at the clinic at the place of residence for further observation. In this case, it is mandatory to sanitize all foci of chronic infection, and the oral cavity in particular. Deworming is also carried out.

Considering that thrombocytopenic purpura is not uncommon in children, part of the responsibility for the further course of the disease rests with the parents. A conversation is held with them about what can provoke a relapse of the disease (ARVI, exacerbation of focal infections). In addition, parents should know how to gradually introduce hardening, physical therapy and keep a food diary (elimination of allergenic foods). To protect the child from injury, he is exempt from school for this period and is advised to study at home.

A person is registered at a dispensary for recovery for at least 2 years. The prognosis of the disease, if it is not thrombotic thrombocytopenic purpura, is usually favorable.

We do not provide information regarding specific clinics, but any hematology department will conduct the necessary examinations and prescribe treatment.

Good evening! My daughter, 7 years old, was diagnosed with “immune thrombocytopenic purpura”, treated with IVs with immunoglobulins and octogam, a year has passed, there are no significant changes, only the nosebleeds and bruises have practically gone away, the doctors are confused, they doubt the diagnosis, they want to take a puncture again. Are there any clear criteria by which such a diagnosis can be made? They were dripped recently, the platelets dropped again to 40. And is there a chance that all this will pass like a bad dream?((

Hello! There are criteria for making such a diagnosis - clinic, platelet level, antibody test, and hematologists know them, naturally. Perhaps they suspect some other disease, which is why they have doubts about purpura. Considering that thrombocytopenia persists, there is no reason to expect that everything will go away. Most likely, your daughter will have to periodically undergo courses of treatment and monitor her platelet levels throughout her life.

Thrombocytopenic purpura in children and adults photo

Skin diseases affect children and adults with equal frequency. One of these diseases is thrombocytopenic purpura. Photos will be discussed in the article. The disease is due to its complex nature and special course. Let's look at how this process occurs in children, how often it occurs in adults, and what treatment methods are considered the most effective for eliminating the disease.

What is thrombocytopenic purpura?

Thrombocytopenic purpura, photos of which are presented below, is one of the types of hemorrhagic phenomenon - diathesis. The disease is characterized by a deficiency of red blood platelets - platelets, which is often caused by the influence of immune mechanisms. Signs of the disease include random effusions of blood into the skin, and they can be multiple or single. The disease is also accompanied by an increase in uterine, nasal and other blood flows. If there is a suspicion of progression of this disease, the task is to evaluate clinical data and other diagnostic information - ELISA, tests, smears and punctures.

This benign pathological disease is accompanied by the fact that there is a deficiency of platelets in the blood, and there is a tendency to increased bleeding and the development of hemorrhagic symptoms. In the presence of a disease in the peripheral blood system, a downward change in the level of blood platelets is observed. Among all hemorrhagic types of diathesis, it is purpura that occurs most often, mainly in children of preschool age. In adults and adolescents, the pathological syndrome is less common and affects mainly women.

According to the course, the disease can be divided into acute and chronic forms. In the first case, the disease occurs in childhood and lasts six months, while platelets are normalized and there are no relapses. In the second situation, the duration of the disease exceeds a period of 6 months and progresses in adults. The recurrent form has a cyclical course, with repeating functions of individual episodes.

Causes of the disease

In 45% of situations, the disease develops spontaneously. In 40% of cases, the development of this pathology is preceded by numerous viral and bacterial infectious phenomena that were experienced a couple of weeks before the onset. Typically, these factors include several diseases.

Often the manifestation of the disease occurs as part of active or passive immunization. Several more factors that provoke the formation of the disease are taking medications, x-ray irradiation, exposure to chemicals, surgical interventions, and insolation.

Symptoms of thrombocytopenic purpura

The onset of any disease and manifestation is particularly acute. The sudden appearance of hemorrhages aggravates the situation and creates the appearance of the integument characteristic of the disease. Against the background of primary symptoms, additional signs arise - nosebleeds, deterioration in general condition, pale skin, a sharp increase in body temperature. If this is an acute process, full recovery without relapse usually occurs after 1 month. As the disease manifests itself, many children experience a noticeable enlargement of the lymph nodes. Due to its mild course, the disease cannot be diagnosed in about 50% of children.

If we are talking about a chronic form of the disease, an acute onset is not provided. The first symptoms appear long before acute symptoms begin. Bleeding occurs in the skin area and looks like pinpoint hemorrhages. They aggravate the overall picture when the disease worsens. In first place among the formations is skin purpura - a rash in a child or adult. Hemorrhagic manifestations usually appear abruptly, mainly at night.

In rare situations, “bloody tears” can be identified as a symptom, which is caused by heavy bleeding from the eye area. Usually this phenomenon is observed together with skin formations. The blood flows persistently and profusely, and anemia may occur against the background of this phenomenon. Gastrointestinal bleeding is less common, but in girls the process may be accompanied by uterine pathologies and discharge. Rarely, purpura may cause hematomas and prolonged bleeding. Children suffering from the disease usually have no complaints, except that a couple of signs can be identified.

• General state of lethargy and apathy;
• increased fatigue;
• normal body temperature;
• normal size of the spleen and liver;
• sharp and severe irritability.

Chronic forms of the disease usually occur in children after 7 years of age. The course is wavy, with remissions and exacerbations alternating.

Thrombocytopenic purpura in children photo

Thrombocytopenic purpura, photos of which are presented in the article, has several forms and manifestations. The main signs of its presence in young children are hemorrhages and effusions into the mucous membranes and under the skin. The color of hemorrhages varies from red to green, and the size of the rash on the face and body ranges from small petechiae to large blisters and spots.

The manifestation is characterized by a lack of symmetry and logic of the sequence of formation. In children, the formations do not hurt or bother. When the stage of clinical remission occurs, the disease disappears and disappears completely.

Cutaneous hemorrhagic syndrome has several specific and characteristic signs of manifestation.

• The severity of the hemorrhagic symptom does not correspond to the traumatic impact. Formations can appear suddenly and unexpectedly.
• During the course of a childhood illness, polymorphism is observed, in which the variety and size of the rashes are different and multifaceted.
• Skin hemorrhage does not have favorite localization sites. For example, a rash may appear on the arms, body, face, rash on the legs and other parts of the body.

The most dangerous manifestation of a childhood illness is the appearance of hemorrhage in the sclera, which can give rise to the most serious complication - cerebral hemorrhage. The outcome of this course depends on the form and location of the pathology, as well as on the therapeutic measures taken. Speaking about the prevalence of the disease, it can be noted that its frequency ranges from 10 to 125 cases per million population over an annual period.

Thrombocytopenic purpura in children treatment

Before prescribing effective treatment methods, a study of the disease is carried out - a detailed diagnosis. It is possible that a decrease in the number of platelets and a longer bleeding time will be detected in the blood. There is not always a correspondence between the duration of this phenomenon and the degree of thrombocytopenia. Secondary indicators of the presence of the disease are altered properties of the blood, changes in hormones in it, as well as other substances.

Differential diagnosis

The disease must be differentiated from a number of other manifestations that are similar in their signs and symptomatic indicators.

• Acute leukemia - in this case, metaplasia appears in the bone marrow area.
• SLE – to make a detailed diagnosis, it is necessary to take into account information from an immunological study.
• Thrombocytopathy involves a change in the content and level of platelets in the other direction.

Therapeutic activities for children

Thrombocytopenic purpura, photos of which are presented in the article, suggests no treatment if the forms of the disease are not severe. For moderate severity, therapeutic interventions are indicated if there is an increased risk of bleeding. Such phenomena are predominantly characteristic of peptic ulcers, hypertension, and duodenum. If the platelet level in the test reaches<20-30×10^9/л, то терапия назначается в стационарных условиях. Если больной человек страдает от хронической формы проявления заболевания, для которой характерны обильные течения крови и попадание жидкости в жизненно важные элементы, проводится спленэктомия. Ребенок во время геморрагического криза должен проводить время в постели.

1. If the therapy is pathogenetic in nature, glucocorticosteroids are prescribed at a dose of 2 mg/kg body weight per day orally, and immunosuppressants are used (cyclophosphamide, vincristine, if other methods are ineffective). All medications are specifically prescribed by a doctor.
2. To eliminate the symptoms and features of the disease, human Ig is used, and the child is given a dosage of 1 g per kg of weight for two days.
3. Danazol, which has an androgenic effect, is often used, as well as drugs from the interferon group - ROFERON-A, REAFERON, ANTI-A.
4. Drugs of the symptomatic group – aminocaproic acid, etamsylate.

Forecasting factors

In most situations, the prognosis is favorable. In children, full recovery occurs in 90% of cases, in adults – in 75%. During the acute stage of the process, noticeable complications may arise in the form of a hemorrhagic stroke, and there is a high risk of death. When carrying out treatment, it is necessary that the sick person is constantly under the supervision of a hematologist, and it is important to exclude from the treatment diet drugs that affect the properties of platelet aggregation. These medications include caffeine, aspirin, and barbiturates.

Thrombocytopenic purpura in adults photo

A rash in adults, along with other symptoms, also occurs. The clinical picture is similar to the manifestations of the disease in children. Spots and formations on the skin do not bother a person. The only caveat is that thrombocytopenic purpura (photo can be seen in the article) among the adult population is 2-3 times more likely to affect the fair sex.

Thrombocytopenic purpura in adults treatment

The treatment complex for children and adults has many similarities, and all therapeutic methods are determined by how severe the disease is and how long it should last. Treatment consists of conservative therapy, which involves taking medications, as well as the use of surgical methods. Regardless of the manifestation of the disease, bed rest is an important part of recovery.

Drug treatment

Previously, remedies for treating the disease in children were described; in principle, they are all suitable for adults, but to simplify the situation and improve the condition, it is recommended to include in the diet hormonal drugs that help reduce vascular permeability and increase blood clotting. If there is multiple rashes on the body, as well as other symptoms, the use of several groups of remedies is effective.

1. PREDNISOONE is used at a dose of 2 mg per kg of body weight per day, subsequently the dosage is reduced. Usually this therapy gives a tremendous effect; patients relapse after stopping hormones.
2. If measures taken in adults do not produce results, immunosuppressants are used. This is imuran, 2-3 mg per kg of body weight per day. Duration of therapy is up to 5 months. Also vincristine 1-2 mg once a week.

The effect of such treatment can be detected after just a few weeks; over time, the dosage is reduced. Patients should also consume a vitamin complex, especially groups P and C. Such measures will make noticeable improvements in the properties of platelets. In addition, doctors prescribe calcium salts, aminocaproic acids, ATP, magnesium sulfate. Collections of natural folk remedies (nettle, rose hips, pepper, St. John's wort) are effective.

If conservative methods of therapy are not particularly effective, it comes to resorting to surgical removal of the spleen. Cytostatic agents are often prescribed to help reduce the number of harmful cells. But these drugs are used exclusively in rare cases (IMURAN, VINCRISTINE, CYCLOPHOSPHAN).

Diet for thrombocytopenic purpura

The main requirement that implies the possibility of quickly getting rid of the disease is adherence to a special diet. The patient's diet should be moderately high in calories and complete. Food is served chilled, it should be liquid and contain small portions. The rash, a photo of which was presented in the article, can quickly disappear if you eat the right foods.

Foods to reduce platelets

There is no specific treatment menu, but the main rule is to get nutritious food with proteins and essential vitamins. The benefit lies in the use of several product groups.

• Buckwheat porridge;
• peanuts and other nuts;
• fruits and juices from them;
• any vegetables;
• corn;
• beef liver;
• cereals;
• wheat and products made from it.

What to exclude from your diet

• spicy and salty foods;
• high fat foods;
• food with impurities and aromatic additives;
• hot spices and sauces;
• restaurant food and fast food products.

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Purpura - types, symptoms, treatment. Allergic vasculitis

Purpura is a hemorrhagic accumulation of blood in tissues, under the skin and mucous membranes. It is expressed in spontaneous bruises, ecchymoses, petichiae and small spots appearing on the surface of the skin.

There are different types of purpura, but in medical terminology and statistics the most common are primary (idiopathic) purpura and secondary, that is, symptomatic. The latter are caused by third-party factors, for example, diseases, infections.

Causes and diagnosis of purpura

Purpura can be thrombocytopenic or non-thrombocytopenic. In the first case, the number of platelets circulating in the blood decreases, in the second, the platelet indicator remains unchanged.

Diseases that cause purpura: multiple myeloma, leukemia, diseases of the bone marrow or spleen, infectious diseases such as German measles or rubella. Purpura can also appear under the influence of narcotic drugs or aggressive chemicals on the body.

The external manifestations of all types of purpura are quite similar. Laboratory analysis is required to distinguish between the different types of purpura. Standard symptoms are: hemorrhages under the skin, bruising, petechiae (red spots with fuzzy edges). The acute form is accompanied by hematuria and nosebleeds, while the temporary coagulation index is normal.

For proper treatment, doctors need to know the type of purpura. To do this, external signs are studied and laboratory diagnostics are carried out. For thrombocytopenic purpura, patients are administered corticosteroids. In some cases, splenectomy (removal of the spleen) is indicated. Idiopathic purpura may disappear spontaneously, especially in children.

General measures to prevent purpura: protection from impacts, injuries, postponement of planned operations, tooth extraction.

Types of purpura, symptoms and treatment

Henoch-Schönlein purpura (vascular, allergic, anaphylactoid)

Henoch-Schönlein purpura (there are also references to this type of purpura as vascular, anaphylactic or allergic, which is essentially the same thing, and different specialists may identify this type of purpura in different ways).

In approximately two thirds of cases, the disease appears after contracting an upper respiratory tract infection, with skin symptoms appearing on average ten days after respiratory symptoms. Despite the popular theory of infectious transmission, no microorganism or environmental factor has been identified as a reliable cause of Henoch-Schönlein purpura.

A distinctive feature of this type of disease is inflammation of blood vessels in the upper layers of the skin. Other symptoms: arthritis, kidney inflammation, abdominal pain. In 90% of cases, the disease is diagnosed in children and resolves within a few weeks. Diseases in adults are more serious, symptoms last longer, and there is a risk of irreversible kidney damage, but its probability is about 5%.

Treatment is carried out with non-steroidal anti-inflammatory drugs.

Hemorrhagic purpura is associated with inflammation of the blood vessels - vasculitis, and occurs due to an incorrect response of the body's immune system to infection. Horses often suffer from this disease. Cases have been reported in which hemorrhagic purpura was the result of bacterial and viral respiratory tract infections. Symptoms are similar to other types of disease, but can be severe, including necrosis of the affected tissue, consequences for the muscles, kidneys and lungs.

Widespread involvement of the body in the pathological process can lead to the appearance of symptoms such as laminitis, colic, weight loss, and disturbances in the functioning of the central nervous system.

Treatment consists of eliminating the root cause of the disease; dexamethasone, corticosteroids, and immunosuppressive therapy are prescribed.

Nonthrombocytopenic (idiopathic) purpura

Nonthrombocytopenic purpura is an allergic reaction of unknown origin that causes red patches to appear on the skin. Often painless, but unaesthetic. Occurs as a result of rupture of capillaries, as a result of which a small amount of blood is released under the skin in the legs, arms, back or absolutely any part of the body. This blood is not absorbed, but accumulates in the tissues. This happens because the capillaries are blocked by protein complexes formed during an abnormal immune reaction. Boys suffer from this disease more often than girls. The peak time for purpura is from late autumn to winter.

Symptoms of nonthrombocytopenic purpura

Headache, fever, loss of appetite, itchy skin, red rash. This rash is red, flat or slightly raised above the surface of the skin, and can be small in size, like a freckle, or slightly larger, resembling a bruise. Initially, the rash turns purple, and then within 24 hours it becomes the color of rust and disappears after a few weeks. Places of occurrence: buttocks, abdomen, lower limbs.

Additional symptoms: muscle pain, swelling of the ankles and knees, blood in the urine, low volume of urine, kidney damage. Renal failure may occur due to capillary obstruction. Sometimes male patients may experience swelling of the scrotum.

Treatment of nonthrombocytopenic purpura

Most cases disappear on their own without treatment, but in case of serious complications (for example, renal function), patients are treated in a hospital. To eliminate joint pain, painkillers are prescribed, and corticosteroids are also indicated. If the kidneys are damaged, it is necessary to correct the level of electrolytes in the blood.

Allergic vasculitis

Vasculitis is inflammation of blood vessels. It can cause blood vessel damage, thickening, scarring, and weakening of vessel cell membranes. There are many different types of vasculitis; some of them are acute and do not last long, while others may be chronic in nature. Allergic vasculitis is an acute form of the disease.

There is inflammation and redness of the skin that occurs when it comes into contact with any external irritant. Red spots appear on the skin, which some doctors simply call purpura. These spots seem to be raised above the surface of the skin, but they can also be flat. Their color ranges from red to purple.

Other common symptoms: joint pain, swollen lymph nodes, kidney inflammation.

The causes of allergic vasculitis may be:

• infections;
• chemical substances;
• food allergens;
• potent medications;
• any substance or material.

Vasculitis is most often caused by the body interacting with medications, but it can also occur in combination with certain infections or viruses. In some cases, the exact cause of such a reaction cannot be identified.

Hypersensitivity in vasculitis is usually caused by a reaction to medications. The most common drugs that can trigger the disease are:

• penicillin;
• sulfonamides (a class of antibiotics);
• some medications for high blood pressure;
• phenytoin.

Allergic vasculitis can also be caused by chronic bacterial infections and viruses, such as HIV or hepatitis B and C. People with an autoimmune disorder called lupus may also suffer from itchy red patches on the skin. If the cause of the disease is an interaction with drugs, symptoms appear within 7-10 days after starting treatment. Some patients may show the first symptoms as early as two to three days after starting medication.

The main treatment is to relieve symptoms such as itching and burning. Allergic vasculitis usually goes away on its own within a couple of weeks. To alleviate the condition of patients, antiallergic drugs are used that reduce inflammation and itching, as well as corticosteroids, aspirin, and herbal medicines.

© 2015 DermNet New Zealand Trust

©15 Healthline Networks, Inc.

© 2015 Regents of the University of Minnesota.

© 2015 Johns Hopkins Vasculitis Center

National Institutes of Health, Department of Health and Human Services

©MedicineNet, Inc.

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