Patient's question:
Burning for 2 days, the hot area is located in the lower limbs, body temperature 37.8 degrees, decreased appetite, red spots reappear on both lower limbs, initially diagnosed as allergic purpura, joint pain and swelling reappear in the limbs, routine urine test shows positive protein in urine, urine sediment test...Doctor's answer:
Purpura is a connective tissue disease with a pathological basis of capillary inflammation. It is characterized by skin purpura, joint swelling and pain, abdominal pain, hematuria, and blood in the urine in clinical diagnosis. Suggestions:1) Avoid contact with allergenic substances.
2) Completely eliminate chronic infection foci and remove intestinal parasites.
3) When blisters occur, large doses of vitamin C, Anluoxue, and hemostatic drugs such as Hemostatic can be used to stabilize vascular permeability and fragility.
4) For abdominal pain, antispasmodic drugs such as Probenecid and Atropine can be used. If there is no perforation, cold compresses can also be applied for the effect of promoting blood circulation.
5) Take diphenhydramine 25–50mg or chlorpheniramine 4mg, 2–3 times daily, as antiallergic drugs. If 10% calcium gluconate is also used in conventional doses, the effect is better.
6) Take prednisone 30–40mg daily, divided into multiple doses. When symptoms improve, the dosage should be increased. The course of treatment is 3–4 months, which has a significant effect on reducing blistering, abdominal pain, and joint pain.
7) When kidney damage occurs and other treatments are ineffective, immunosuppressants such as azathioprine can be added to corticosteroid use. 50mg per dose, 2–3 times daily. After the effect takes hold, the dose should be maintained at 25–50mg per dose, 2–3 times daily, until proteinuria becomes negative. Then, switch to alternate-day single doses for a 6-month course.
8) In cases of perforation or other acute abdominal conditions and severe hemorrhagic shock, immediate hospital treatment should be sought. This disease often resolves on its own but can recur. The average course of the disease is 4 weeks (1–6 weeks). The duration of the course is related to the following factors:
(1) Severity of the acute phase;
(2) How severely important organs are affected;
(3) How frequently it recurs.
Simple skin-type and joint-type patients have a shorter course of about 1–2 weeks; abdominal-type patients have a course of about 3–5 weeks; kidney-type patients have the longest course, which can last for 4–5 years or more.
The prognosis for this disease is generally good. The prognosis is better for skin-type and joint-type patients. Abdominal-type patients have a good prognosis if they do not have complications such as intussusception or intestinal obstruction. Most kidney-type patients can recover completely with treatment. If the condition persists without improvement, it may progress to chronic renal failure or uremia.