What are the conditions that must be differentiated from Henoch Schonlein purpura?

1) Skin type. It should be distinguished from drug eruptions or thrombocytopenic purpura. There is a certain history of drug use, and the rash is often distributed throughout the body, and the drug rash can disappear after stopping the drug.

The ecchymosis of thrombocytopenic purpura can be irregularly distributed, the rash is not raised, and there are no papules and urticaria. Platelet count is low, bleeding is prolonged, and bone marrow is unchanged.

2) Articular type.

Patients with painful joint swelling should be distinguished from rheumatoid arthritis, which is often rheumatic activity, and serum anti-O antibodies and erythrocyte sedimentation rate are markedly elevated and elevated. The main manifestations are acute migratory and asymmetric polyarthritis, which is red, swollen, hot and tender, and limited movement, which can help distinguish them.

3) Abdominal type. Patients with abdominal pain and Henoch-Schonlein purpura should be distinguished from acute abdomen, which generally has no muscle tension and rebound tenderness in addition to abdominal pain and diarrhea, while acute abdomen has muscle tension and rebound tenderness in addition to abdominal pain, which can help distinguish it.

4) Renal type. It must be distinguished from acute glomerulonephritis, lupus nephritis, renal tuberculosis, etc. glomerulonephritis without **purpura, abdominal and joint symptoms; Lupus nephritis has multiple organ damage, leukopenia, and increased erythrocyte sedimentation rate. Positive for lupus cells and other immune markers.

The incidence of Henoch-Schonlein purpura nephritis in pediatric nephrology is on the rise, and the course of the disease is prolonged and difficult to heal, which brings great harm to children's health. Experts say that Henoch-Schonlein purpura nephritis is generally mild in the early stage, and in the middle and end stages, it transforms into renal insufficiency and even uremia, then Henoch-Schonlein purpura nephritis will be life-threatening.

Anaphylactoid purpura, also known as self-limited acute hemorrhage, is an allergic vasculitis that invades the arteries and capillaries of ** and other organs, and the cause may be pathogen infection, the effect of certain drugs, allergies, etc., resulting in the formation of IgA or IgG circulating immune complexes in the body. Deposition in the capillaries of the upper dermis causes vasculitis. The main manifestations are purpura, abdominal pain, arthralgia, and renal damage, but no thrombocytopenia. Henoch-Schonlein purpura and allergic vasculitis are thought to belong to the same spectrum.

This disease is the most common vasculitis in childhood, which occurs more often in school-age children, and the common age of onset is 7 to 14 years old, and it is rare in infants under 1 year old.

Clinical presentation. Speech is more common in children and adolescents, and may initially cause fever, headache, joint pain, and general malaise.

1.**。Most of them have **purpura as the first symptom. Skin lesions appear as pinhead-to-soybean-sized petechiae, ecchymosis or urticaria-like rashes, or pink maculopapular rashes that do not fade when pressed, and purpura is the episodic lesion. Purpura can fuse into patches and eventually turn brown.

It usually fades within 1 to 2 weeks without leaving a trace. In severe cases, blisters, blood blisters, necrosis and even ulcers may occur. The rash usually occurs in weight-bearing areas and is more likely to occur on the extensor sides of the extremities, especially on the lower extremities, around the ankle joints, and on the buttocks.

Lesions are symmetrically distributed, appear in groups, and are prone to **. Only ** damage is also called simple purpura, 2Digestive system.

About 2 to 3 cases developed gastrointestinal symptoms. The rash usually appears within 1 week of the onset of the rash. Abdominal pain is common, mostly manifested as paroxysmal periumbilical pain, cramping, and abdominal pain can also occur in other parts of the abdomen.

May be tender, and rebound tenderness is rare. It is accompanied by vomiting. About half of the children were positive for occult blood in the stool, and some of them had bloody stools or even vomited blood.

If abdominal pain precedes the symptoms, it is easy to misdiagnose it as a surgical acute abdomen, or even to perform surgery by mistake. A small number of children may be complicated by intussusception, intestinal obstruction, intestinal perforation, and hemorrhagic enteritis. People with abdominal pain, diarrhea, blood in the stool, and even gastrointestinal bleeding are also called gastrointestinal purpura.

3.Urinary system.

Most patients present with gross hematuria or microscopic hematuria and proteinuria, or casts of urine 2 to 4 weeks after purpura. Urinary symptoms can occur at any time during the course of the disease, after the rash has resolved, or during the quiescent phase of the disease. The disease can range from mild to severe, with renal failure and hypertension occurring in severe cases.

More than half of the affected children have kidney damage that resolves clinically on their own. Patients with hematuria, proteinuria, and renal impairment are also called nephrogenic purpura.

Henoch-Schonlein purpura has an acute onset and the sequence of symptoms may vary. The first symptom is **purpura, and a small number of patients first develop abdominal pain and arthritis.

or renal symptoms. A history of upper respiratory tract infection is common in the first 1 to 3 weeks of illness, accompanied by systemic symptoms such as low-grade fever, loss of appetite, and fatigue. Henoch-Schonlein purpura is a vasculitis caused by abnormal immune function.

The main manifestations are symmetrical purpura of the limbs after contact with allergens, and subcutaneous hemorrhage spots. If there is only ** manifestation, it is simple Henoch-Schonlein purpura, and if it is combined with gastrointestinal bleeding, renal insufficiency and other symptoms, it is compound Henoch-Schonlein purpura.