10-year-old Xiao Yuan ate at a restaurant at noon, and his stomach hurt in the afternoon, and he felt nauseous. Mom thought that Xiaoyuan had eaten too much at noon, so she gave him some medicine to eliminate his appetite. After 1 hour, there was no improvement, so I took Xiaoyuan to a nearby hospital to see a doctor. The doctor said that it was acute gastroenteritis and hurriedly gave anti-inflammatory injections and painkillers. However, 3 days later, Xiao Yuan still had stomach pain. On the 4th day, gastroscopy and colonoscopy were performed, and many small red rashes were found on the gastric mucosa and intestinal mucosa. On the 5th day, Xiaoyuan also had many small red rashes on his calves, and red blood cells and proteins appeared on the urinalysis test.
In the end, Xiaoyuan was diagnosed with Henoch-Schonlein purpura! Purpuric nephritis.
This was a case I received in the outpatient clinic the other day. Henoch-Schonlein purpura is a systemic capillary inflammation with a variety of clinical manifestations with a variety of clinical manifestations such as purpura, joint pain, gastrointestinal symptoms (abdominal pain, vomiting, bleeding in the stool) and renal damage. Most children first develop **purpura, and then or at the same time have joint pain, abdominal pain and other symptoms, which is easy to diagnose at this time. A small number of children develop abdominal pain or joint pain first, while purpura does not appear until a few days later, which is often misdiagnosed as a digestive tract disease. Some children were misdiagnosed with appendicitis and stomach bleeding due to abdominal pain, and ended up on the operating table.
It should be reminded that the abdominal pain, joint pain, and purpura that appear in Henoch-Schonlein purpura often seem serious, but they are only superficial, and the biggest harm of the disease is kidney damage. Because the kidneys are rich in blood vessels, they are the most susceptible parts, and 70 to 90% of patients with purpura will have varying degrees of kidney damage. Even if there is no problem with several urinalysis tests, follow-up should be repeated for 3 to 5 years.
The medical community believes that the allergens that cause Henoch-Schonlein purpura are: infections (such as bacteria, viruses, parasites, etc.), food (such as milk, fish and shrimp, meat, eggs, snacks, etc.), drugs (such as antibiotics, sulfonamides, antipyretic analgesics, vaccines, etc.). Therefore, after the illness, it is necessary to pay attention to controlling the intake of foods that are easy to cause allergies, such as eggs, milk, fatty meat, mutton, fish and shrimp; Raw and cold food should be eaten with caution; The daily diet of the elderly should be light, the staple food can choose porridge, steamed bread, noodles, vegetables can choose cabbage, cucumber, eggplant, bamboo shoots, tomatoes, etc. For non-seasonal vegetables and non-native fruits, they should be avoided as much as possible.
Regarding the disease, the combination of traditional Chinese and Western medicine is more effective, and it is recommended not to abuse hormones. Traditional Chinese medicine believes that 90% of the disease is caused by internal heat, so it should clear heat, detoxify and cool the blood, starting from the control of internal heat, Shengdi, Danpi, red peony, buffalo horn powder, etc. are commonly used drugs for Henoch-Schonlein purpura.