Henoch-Schonlein purpura, also referred to as anaphylactoid purpura, is a distinct systemic vasculitis syndrome that is characterized by palpable purpura (most commonly distributed over the buttocks and lower extremities), arthralgias, gastrointestinal signs and symptoms, and glomerulonephritis. It is a small vessel vasculitis.
Henoch-Schonlein purpura is usually seen in children; most patients range in age from 4 to 7 years; however, the disease may also be seen in infants and adults. It is not a rare disease; in one series it accounted for between 5 and 24 admissions per year at a pediatric hospital. The male-to-female ratio is 1.5:1
(1)The presumptive pathogenic mechanism for Henoch-Schonlein purpura is immune-complex deposition. A number of inciting antigens have been suggested including upper respiratory tract infections, various drugs, foods, insect bites, and immunizations. IgA is the antibody class most often seen in the immune complexes and has been demonstrated in the renal biopsies of these patients
(3)Respiratory infectious diseases
(4)Food and drugs allergy
Clinical and labaratory manifestations
(1) In pediatric patients, presenting symptoms related to the skin, gut, and joints are present in 50% of cases.
(2) In adults, presenting symptoms related to the skin are seen in over 70% of patients, while initial complaints related to the gut or the joints are noted in fewer than 20% of cases.
(3) The typical palpable purpura is seen in virtually all patients; most patients develop polyarthralgias in the absence of frank arthritis. Gastrointestinal involvement, which is seen in almost 70% of pediatric patients, is characterized by colicky abdominal pain usually associated with nausea, vomiting, diarrhea, or constipation and is frequently accompanied by the passage of blood and mucus per rectum; bowel intussusception may occur rarely.
(4) The renal involvement is usually characterized by mild glomerulonephritis leading to proteinuria and microscopic hematuria, with red blood cell casts in the majority of patients; it usually resolves spontaneously without therapy. Rarely, a progressive glomerulonephritis will develop. Renal failure is the most common cause of death in the rare patient who dies of Henoch-Schonlein purpura..
(5) Myocardial involvement can occur in adults but is rare in children.
(6) Routine laboratory studies generally show a mild leukocytosis, a normal platelet count, and occasionally eosinophilia. Serum complement components are normal, and IgA levels are elevated in about one-half of patients.
Clinical treatment results
The prognosis of Henoch-Schonlein purpura is excellent. Most patients recover completely, and some do not require therapy. Treatment is similar for adults and children. When glucocorticoid therapy is required, prednisone in doses of 1 mg/kg per day and tapered according to clinical response has been shown to be useful in decreasing tissue edema, arthralgias, and abdominal discomfort; however, it has not proven beneficial in the treatment of skin or renal disease and does not appear to shorten the duration of active disease or lessen the chance of recurrence.
By using pure Chinese medicine therapy (after non-effective western treatment-no response towards glucocorticoids), there are 157 cases. Among them, the longest course of disease is 5 years and the shortest is 6 months. From them, 147 cases are fully recovered (healthly); symptoms disappeared, proteinuria and hematuria are absent and their normal life routine is recovered. While the rest of 11 cases are effective with whole body symptoms disappeared, absent of proteinuria but hematuria is remained.
Those who used purely Chinese medicine from the beginning have 30 cases, male 21, female 9; age range 8-15 years old. The course of disease took place within 6 months-21 cases, 6 months to 1 year-9 cases. They had decreasing in hematuria in average and resulthe in full recovery (purpura disappeared, normal urine analysis). Their effectiveness is 100%. Their average medicine intake is about 15 days.