Anaphylactic Purpura Nephritis

What is anaphylactic purpura nephritis?
Anaphylactic purpura nephritis, also known as Henoch-Sch?nlein purpura, is a kind of immunological disease with necrotizing vasculitis as its Fundamental pathological changes. It is featured by skin purpura, hemorrhagic gastroenteritis, arthritis and renal damage on clinical manifestation. The damage on renal are called purpura nephritis, which may occur in any age.
Causes
Henoch-Schonlein Purpura Nephritis is autoimmune disease. In normal case, the immune system can protect the body from the foreign pathological substances invading into body. Therefore, the body can keep in a healthy and normal state. However, in some cases, the immunity system is activated improperly. As a result, the complexes of immunoglobulin A (IgA) and complement component 3 (C3) are deposited on arteries, capillaries and venules. Afterwards, these immune complexes will be carried to glomerular mesangial are by blood circulation. As the kidneys have specific blinding epitopes, the immune complexes will deposit in glomeruli mesangial cells. The body mounts an inflammatory response to remove the immune complexes. Ultimately, the inflammation can cause damage to and impair the function of the glomeruli, leading to Henoch-Schonlein Purpura Nephritis.
Clinical symptoms of anaphylactic purpura nephritis
The clinical manifestations of anaphylactic purpura nephritis are divided into two aspects: Extra renal manifestations and renal involvement manifestation. Extra renal manifestation is characterized by skin purpura, arthralgia and celialgia. Renal involvement manifestation is characterized by simple hematuria and hematuria accompanied proteinuria. The skin purpura is hemorrhagic freckle, raised and has the pruritus. They are distributed in distal extremities, hip and lower abdomen, presenting in symmetrical distribution. They always disappear in one or two weeks. About 2/3 of the patients will have the joint pain at the same time. About 1/4 of the patients have the symptoms of Cramps, diarrhea.
The renal involvement manifestations of purpura nephritis are mainly simple hematuria and hematuria accompanied little proteinuria. The form of hematuria is microscopic hematuria and nakea hematuria. 80-85 percent of the cases may have the symptoms of renal involvement in four weeks or a few months after the extra renal manifestations such as tetter, arthralgia and abdominal pain. There also some patients will first have the symptoms of hematuresis, then have tetter. A few patients get the symptoms of nephritic syndrome of renal damage.
Key points on the diagnosis of anaphylactic purpura nephritis
1. The patients have a medical history of skin purpura, arthralgia and stomachache and the skin purpura is the essential condition. Some of the patients may have the repeated skin purpura.
2. The patients have the manifestations of renal involvement such as hematuresis and proteinuria. Some of the patients may have the symptoms of nephritic syndrome or renal damage. About 25% of the anaphylactic purpura nephritis patients have a slight renal involvement, and the repeated urine routine test is needed.
Dietetic and health-care of anaphylactic purpura nephritis
The diet therapy of anaphylactic purpura nephritis should be conducted on certain principles: for one side, to prevent allergy; for the other side, to tonify the kidney and reduce the damage to kidney. The principles in detail are in the following:
Stop eating the food that may caused allergy, such as milk, fish, shrimp, crab and mutton. Food should be chose on the basis of the anaphylactic purpura nephritis type.
The diet should be delicate, nourishing and digestible, avoiding the improper diet. Avoid fat food or overeating; avoid coarse fare grain or the high-fiber food, but try the refined food. No bacon and barbecue food are allowed. Uncooked meat and stimulating food should also be avoided. For patients with hypertension or edema, they should also limit the intake of salt.
Prognosis of anaphylactic purpura nephritis

The average duration of the disease is 1 month, even though it may run a protracted course over several years and there is a tendency for recurrences. Successive episodes of purpura are common during the first weeks of disease but rarely occur beyond the third month. A single attack seldom lasts more than 1 week, and attacks of purpura are associated inconstantly with exacerbation of renal symptomatology. Although the disease is usually self-limited with a good eventual outcome, the glomerulonephritis associated with HSP may uncommonly lead to renal failure. For that reason, persistent proteinuria should probably be aggressively treated with angiogenesis-converting enzyme inhibitors in patients with HSP.