Vasculitis

Vasculitis is a disease caused by an inflammatory process in a wall of blood vessels, often associated with thrombosis of the lumen of the vessel and inflammatory phenomena in the surrounding tissues. Vasculitis may accompany a variety of infectious and infectious-allergic diseases (typhus, typhoid fever, rheumatic fever, septic diseases and others) or to exist independently, affecting mainly the skin vessels.
With the defeat of surface vessels of the skin, mainly arterioles and capillaries in the skin appear rash: spots, papules, the centers superficial necrosis, petechiae. When vasculitis, affecting the arteries and veinsthat are located deep in the dermis, and the subcutaneous tissues in the skin formed knotted painful infiltrates various sizes, plotnosti to the touch, the skin over them hyperemic and stretched. This group of vasculitis, called nodular vasculitis, more common in middle-aged women; localized rash on the lower extremities. Nodular Vasculitis can occur acutely and chronically and often due to focal infection (see Erythema nodosum).
Among vasculitis with predominant lesion of skin vessels emit disease Guiera - Duperre by which the skin of the lower legs and thighs appear rash in the form of multiple inflammatory painful knots to 0.5 cm in diameter, slightly above the skin, spots and bleeding, not disappearing when pressed. The rash appears attacks against the background of relatively good overall condition of the patient and allowed for 15 to 60 days, sometimes accompanied subfebrile temperature, pain in the joints, complicated by argued.
The most common hemorrhagic vasculitis (synonym: purpura nervosa, anaphylactoid purpura, trombopenica purpura, Shenleina's disease disease), which is a disease of the vascular system, pathogenetically close rheumatism, affecting along with the skin vessels and vessels of internal organs. Hemorrhagic rash on the skin (purpura) and changes in the joints and internal organs due to increased permeability of blood vessels and the violation of the wall (see below Hemorrhagic vasculitis in children).
Treatment. Antihistamines (diphenhydramine 0.03 g or suprastin 0,025 g 2 times a day, and others); ascorbic acid 0.25 g, rutin 0.02 g gluconate calcium 0.5 g orally 3 times a day; intravenous infusion of 10% solution of calcium chloride 10 ml within 10 days, in severe cases, corticosteroids by a doctor.
Cm. also Nodosa nadasny.

Hemorrhagic vasculitis in children

Hemorrhagic vasculitis in children severe, occurs more often in pre-school and school age. The greatest number of diseases occurs in spring and autumn.
There are two main forms of illness: for skin and joint and abdominal. The illness usually begins suddenly, often after a previous infection (such as angina), and errors in the diet. The temperature rises to 38-39°, pale skin appears exudative-hemorrhagic rash (purpura), which is located symmetrically, mainly on the extensor surfaces of the limbs, around large joints and in the buttocks. Often report volatile joint pain and cramping abdominal pain, accompanied by vomiting and bleeding from faeces. Often along with purpura swollen large joints, swelling of the face, hands, feet, legs type of swelling Kwinke (angioneuroticeski swelling). Accession diffuse hemorrhagic jade indicates the presence of hematuria. Changes in the kidneys say 2-3 weeks, which significantly worsens the prognosis of the disease due to the possibility of developing kidney failure.
Differential diagnosis should be carried out with rheumatism, multiforme exudative erythema, disease Verligofa (see thrombocytopenic Purpura). In addition to the General analysis of blood and urine, it is necessary to investigate the protein composition of venous blood, time of blood clotting, the duration of bleeding, the number of platelets; cal explore occult blood. Abdominal form often mimics appendicitis, the industry and other forms of acute abdomen.
For hemorrhagic vasculitis wavy, disease duration from 2-3 weeks to several years.
Forecast in respect of life in the majority of cases favourable.
Treatment. In all cases of hemorrhagic vasculitis required hospitalization, strict bed rest. A sick child requires constant supervision of the doctor as possible swelling of the larynx, and the abdominal form - intestinal bleeding, check it out here. Patients designate a Dimedrol and calcium chloride, vitamin C, rutin, in severe cases, antibiotics, prednisolone, intravenous administration of 0.5% solution novokaina.
Prevention. Sanitation of the centers of infection, elimination of allergens in food; it is necessary to avoid exposure and to protect children from acute infections.