Henoch-Schönlein purpura is a vascular inflammation involving small vessels, the exact cause of which is unknown, and the joints, gastrointestinal system, kidneys and, less commonly, other organs are affected, especially the skin.
It is seen in childhood. It is the most common small vessel inflammation without a decrease in blood platelets. Since it is generally seen in the 5-15 age group, it can be considered as a childhood disease.
The annual incidence of the disease under the age of 17 is estimated to be 15/100,000. Clinical diagnostic criteria are used for the diagnosis of Henoch-Schönlein. These criteria are; 1. a skin lesion that is seen without a drop in blood platelets, slightly raised from the skin, with a tendency to bleed that can be felt by touch, The patient's age is under 20 at the time of the first symptoms, There are signs of intestinal involvement such as widespread abdominal pain aggravated by meals or bloody diarrhea, The pathogenesis is not fully understood. Although it is not known, antibodies called immunoglobulin A are thought to play a very important role. The level of immunoglobulin A in the blood is usually increased due to increased production or decreased filtration by the kidneys.
Complex accumulation and inflammation containing immunoglobulin A are seen in the small vessels of the involved organs. The fact that 2/3 of the patients have a history of upper respiratory tract infection and the disease is more common in winter and spring months when respiratory tract infections are intense; It may be coincidental, as well as suggesting that it is associated with infectious diseases. At this point, the most emphasized microorganism is streptococci.
It is also known that it develops after many viral and bacterial infections. Subcutaneous hemorrhages are seen in almost all patients with clinically Henoch-Schönlein purpura, without reduction in platelets on the skin of the hip and lower extremities. Less frequently, rheumatism and swelling, especially in the lower extremity joints, abdominal pain due to gastrointestinal involvement, blood in the stool, blood in the urine due to kidney involvement, and protein leakage in the urine can be seen.
Henoch-Schönlein purpura nad, a mostly benign disease Although it may cause death or chronic diseases, especially due to kidney involvement or gastrointestinal involvement. The treatment of Henoch-Schönlein purpura is mainly supportive. While most patients with only skin and joint involvement show improvement without leaving the disease with bed rest, hydration and painkillers, cortisone treatments are used in gastrointestinal, kidney and other organ involvements.
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