The more "+" the urine protein has, the more difficult it can be cured?Urine pr...Read more
Patient: I was diagnosed with latent nephritis eight years ago, and recuperati...Read more
Identify kidney disease by backpain!Lumbago caused by kidney disease include th...Read more
Two steps to reduce both protein and occult bloodDuring the regular treatment, ...Read more
Henoch-Sch?nlein purpura nephritis is one of common secondary glomerulonephritis, Henoch-Sch?
Pathogenesis of Henoch-Sch?nlein Purpura Nephritis is the allergic reaction caused by infection of bacterium, virus, parasite, etc
1.Common treatment: in acute period, patients should stay on bed, and pay attention to keep warm, stop take anaphylaxis medicine and food, avoid touch allergen, if patients feel obvious stomachache and hemafecia should take H2 receptor blocking pharmacon, intramuscular injection vitaminK1, atropine,etc. Appropriate make use of antiallergic, anti-infection, decompression, diuresis treatment.
2.Glucocorticoid, if patients clinical manifestation is Nephrotic Syndrome or urine protein quantitation >1g/d, Pathological presentation is activity proliferative, then patients can take glucocorticoid, hormone can reduce proteinuria,remission symptom of gastrointestinal tract, joint sore pain and skin purpura.
3.immunosuppressor, for patients with obvious immunosuppressor, only take hormone and the effect is not very well, patients can take other immunosuppressor at the same time, such as cyclophosphamide, mycophenloate, cyclosporin, leflunomide, mizoribine,tripterygium glycosides and so on.
4.renin-angiotensinsystem blocker( RAS), patients can take angiotensin converse enzyme inhibitor( ACEI) or angiotensin receptor inhibitor(ARB), such as benazepril or losartan. This kind of medicine not only can decrease blood pressure,but also reduce proteinuria, Kidney inflammation and fibrosis, during patients take this kind of medicine should prevent low blood pressure, cough, hyperkalemia and other adverse reaction.
5.anticoagulant therapy, dor patients with crescentformation, obvious fibrin deposition or Nephrotic Syndrome,patients can take heparin,dipyridamole,Clopidogrel sulfate and other anti-freezing and antiplatelet treatments.
The symptoms of Henoch-Sch?nlein purpura nephritis( HSPN) can divide into the whole body symptoms and kidney symptoms.
The whole body symptoms
HSPN also involve skin,gastrointestinal tract,joint and kidney in,however, in clinic, not all the patients have the above symptoms. The whole body symptoms is fever,tired and weak, dermatosis is often appear on arms and legs, it also can appear other part of body, manifestation is hemorrhagic rash, press it and fastness, the demarcation of rash is clear or related,if patients do skin biopsy, it shows that IgA immune complex deposit.25%~90% patients appear gastrointestinal tract manifestation, such as abdominal cramps, nausea, vomiting, bloody stools.Joint lesion is often involve ankle joint, knee joint in, the manifestation is joint pain, joint swelling.
The kidney symptoms
Through routine urianlysis we can fine that 40%~60% patients with anaphylactoid purpura suffered HSPN.Generally speaking, after the whole body symptoms and sign appear several days or weeks later, take place avidity kidney lesion, the manifestation is microscopic hematuria and proteinuria, although children with HSPN no kidney disease clinical manifestation, urinalysis still show red cell exceed the normal scope, some patients clinical manifestation is Nephrotic Syndrome, few patients clinical manifestation is renal insufficiency. The clinical manifestation of extra-renal is not obvious related to kidney lesion serious extent, part of patients can take kidney damage manifestation as the HSPN first manifestation.
On the one hand, the diagnoses of Henoch-Sch?nlein purpura nephritis( HSPN) must conform to the following condition.1.patients have the extra-renal manifestation of Henoch-Schonlein purpura, such as skin purpura, etc 2.Patients have the clinical manifestation of kidney damage, such as hematuresis, proteinuria,high blood pressure, renal insufficiency, etc
3.the kidney biopsy show mesangial proliferative and IgA deposit on mesangial region.
On the other hand, diagnoses Henoch-Sch?nlein purpura nephritis( HSPN) should through all kind od test to make sure pathological change, such as light microscopic examination, immunofluorescence examination, electron microscopy, etc
1.The typical light microscopic examination characteristic of HSPN is mesangial proliferative nephritis, accompanied by different extent crescentformation.
2.immunofluorescence examination show immune globulin deposit in glomerulus, the dominant sector of immune globulin is IgA, IgG, IgM and C3 is often deposit together, the main deposit parts is mesangial region, sometime appear on subendothelial
3.electron microscopy show electron dense material deposit on glomerular mesangial area, accompanied by mesangial cell proliferation and mesangial matrix increased, electron dense material also can deposit on subendothelial, the main electron dense material is IgA, C3, IgG.
1.Salt If people with HSPN no swelling and high blood pressure can normal intake salt, on the contrary, if people with HSPN appear swelling and high blood pressure should limit salt intake, because og salt can make swelling hard disappeared and make high blood pressure higher, then make the patients condition aggravate, generally speaking, every day intake salt should 2~3g, if it necessary should no salt diet.
If people with HSPN appear swelling should strict control water intake, if intake too much water will aggravate swelling, and make people condition worse, if people with HSPN no swelling can intake large number of water, increase urine volume and discharge toxin.
People with HSPN have a high require for protein, due to high protein food will aggravate kidney burden, however, low protein diet will reduce patients immunity, swelling and infection are easy relapse and make patients condition worse, so, patients should eat some high quality protein food, such as white eggs, lean, milk and so on.
4.Quit smoke and drink, diet should contain rich nutrition and easy digestion, for people with hematuria should avoid spicy food, sea food and other irritating food