Treatment Of Henoch-Schonlein Purpura Research Articles

A Case Study: Henoch-Schonlein Purpura in a Geriatric Patient with Gastrointestinal Involvement

IgA-mediated immune vasculitis known as Henoch-Schonlein purpura affects the small blood vessels in the joints, kidneys, GI tract, skin, and, less frequently, the brain and lungs. The present case report describes a 62-year-old female patient with Henoch-Schonlein purpura (HSP). HSP is a type of vasculitis that affects small vessels and is characterized by purpura, arthritis, abdominal pain, and kidney involvement. In this case, the patient presented with a rash with red lesions on the upper and lower limbs, crusted lesions on both lower limbs, and acute onset abdominal pain with hematochezia. Endoscopy revealed diffuse ulcerations in the stomach, duodenum, and right colon(fig.1). Biopsies revealed a leukocytoclastic vasculitis in the skin (fig2) and gastrointestinal tract. The patient had a history of hypertension and smoking, and laboratory investigations revealed leucocytosis, anaemia, and electrolyte imbalances. The diagnosis of HSP was made based on the clinical presentation, laboratory findings, and biopsy results. The patient was treated with a combination of steroids, antibiotics, and supportive care, which led to significant improvement of symptoms and laboratory findings. Steroid therapy was given according to guidelines for the treatment of HSP, and tapering the steroid therapy helped to improve gastrointestinal symptoms. The case report highlights the importance of careful monitoring and appropriate treatment of HSP in geriatric patients, as well as the potential benefits of immunosuppressant therapy.

Progress in the Treatment of Henoch-Schonlein Purpura in Children

Henoch-Schonlein Purpura (HSP) is the most common leukocyte fragmentary vasculitis with IgA immune complex deposition in childhood, which may affect capillaries, arterioles and venules in various systems of the body. Henoch-Schonlein purpura nephritis (HSPN) can be diagnosed when kidney damage occurs in children with HSP, which is the most severe complication of HSP. However, if the treatment of children with HSPN is delayed or recurrent, more than 20% of these children eventually develop chronic renal failure, seriously affecting the prognosis and quality of life of the children. Therefore, early diagnosis and treatment are crucial to the prognosis of children with HSP. This article reviews the treatment of HSP and HSPN.

Efficacy Analysis of Glucocorticoids in the Treatment of Allergic Purpura in Tibetan Children

Background: Henoch Schonlein Purpura (HSP) is a common immune-related allergic disease in children. It is very important to understand the clinical features of this disease for doctors. Objective: To explore the clinical efficacy of glucocorticoids in the treatment of HSP in Tibetan children at high altitude, and to analyze the possible causes of HSP in children at high altitude. The risk factors of the disease provide a reference for the treatment of HSP in children in high altitude areas. Methods: Selecting January 2015 to November 2020, 88 children diagnosed with Henoch-Schonlein Purpura in the outpatient and inpatient departments of the People’s Hospital of Bomi County, Tibet Autonomous Region were the subjects of the study. Its gender, age of onset, season of onset, predisposing factors, allergy history, first symptoms, clinical manifestations, laboratory examinations, etc., perform retrospective analysis. Results: Among 88 children with allergic purpura, 55 were boys, accounting for 62.5%, and 33 were girls, accounting for 37.5%. Men have more cases than women. All have clinical manifestations of purpura of the skin, among which 35 cases have obvious triggers, of which the above there were 26 cases of respiratory infections, 6 cases of dietary factors, and 3 cases of contact with allergic substances. Simple skin type: 18 cases, accounting for 20.45%; Abdominal type: 6 cases, accounting for 6.82%; 2 male cases, accounting for 33.33%; 4 female cases, accounting for 66.67%; Articular type: 8 cases, accounting for 33.33%; Renal type: 2 cases, accounting for 2.27%; 54 cases of mixed type, accounting for 61.36%. After glucocorticoids, the rashes disappeared, no any adverse reactions. Conclusion: Allergic purpura in children is more common in school-age children, and upper respiratory tract infection is the main predisposing factor. Skin purpura is the main clinical manifestation, often associated with lower extremity joint swelling and pain. There is no significant difference in the efficacy and course of the disease between intravenous and oral treatment. Therefore, clinicians should strictly grasp the indications of glucocorticoids to reduce the occurrence of complications.

RhACE2 - playing an important role in inhibiting apoptosis induced by Ang II in HUVECs.

Background:Henoch-Schonlein purpura (HSP) is a common hemorrhagic disease, which manifests the inflammation in the body's most microvasculars. Angiotensin II (Ang II) can induce the damage and apoptosis of vascular endothelial cells while angiotensin converting enzyme 2 (ACE2) can antagonist the action of Ang II. However, the effect of ACE2 on Ang II-induced endothelial damage remains unknown.Objective:To evaluate the effect of recombinant human angiotensin converting enzyme 2 (rhACE2) on the Ang II-induced damage of human umbilical vein endothelial cells (HUVECs) and the release of inflammatory mediator in vitro.Methods:Cultured HUVECs were randomly divided into 6 groups: the control group, rhACE2 group, Ang II group, and Ang II+ rhACE2 groups (3 subgroups). The cell vitality, cell cycle, apoptosis rate of the HUVECs and the levels of reactive oxygen species (ROS), interleukin 8 (IL-8), tumor necrosis factor-α (TNF-α), transforming growth factor-β1 (TGF-β1) and lactate dehydrogenase (LDH) were measured, respectively.Results:Compared with the control group, the cell viability and the rate of S phase cells in Ang II group significantly decreased (P < .05) while the apoptosis percentage and the levels of ROS, IL-8, TNF-α, TGF-β1, and LDH in Ang II group significantly increased (P < .05). There were no significant differences between the control group and rhACE2 group. Compared with the Ang II group, the cell viability and the rate of S phase cells in Ang II+rhACE2 groups were higher (P < .05) and the apoptosis percentage, the level of ROS, IL-8, TNF-α, TGF-β1, LDH in Ang II+rhACE2 groups were lower (P < .05).Conclusions:Ang II can induce the apoptosis of HUVECs and the release of inflammatory mediator, while rhACE2 can inhibit the detrimental effects of Ang II. The results of this study suggest that rhACE2 has a protective effect on HSP, which is probably a new way for the prevention and treatment of HSP.

Progress in treatment of henoch-schonlein purpura in children

Henoch-schonlein purpura is a common immune-mediated systemic vasculitis in childhood, and its clinical manifestations are mainly skin purpura, arthritis, gastrointestinal symptoms and acute glomerulonephritis.Clinically, purpura nephritis caused by henoch-schonlein purpura has seriously jeopardized children's life and health.At present, there is still no uniform treatment standard for the treatment of this disease.This article reviews the progress of the treatment of anaphylactoid purpura in children from two aspects of western medicine and traditional Chinese medicine. Key words: Henoch-schonlein purpura; Child; Therapy

Effect of Montmorillonite powder on intestinal mucosal barrier in children with abdominal Henoch-Schonlein purpura: A randomized controlled study.

Background:Our previous studies found that intestinal barrier function has been changed in children with abdominal Henoch–Schonlein purpura (HSP). Montmorillonite has been shown to be protective for digestive tract mucosa.Objective:The present study aimed to investigate whether Montmorillonite powder could improve the intestinal mucosal barrier function in children with abdominal HSP.Methods:Using a randomized controlled study design, we compared plasma levels of diamine oxidase (DAO), d-lactate, and endotoxin in children with abdominal HSP before and after Montmorillonite powder treatment.Results:Among 28 patients in experimental group and 30 in control group, there was no significant difference in age, sex, height, weight, and course of disease between 2 groups (P > .05). Before treatment, there was no statistical difference in DAO, d-lactic acid, and endotoxin between experimental group and the control group (P > .05). However, significant differences were detected for DAO and d-lactate after treatment in comparison to before treatment in the Montmorillonite experimental group (P < .05). Such differences were not found in the control group (P > .05).Conclusion:Montmorillonite powder is effective in the treatment of HSP via maintaining intestinal mucosal barrier function.

Clinical study of the Liangxue-Zhuyu decoction combined with montelukast in the treatment of henoch schonlein purpura

Objective To study the efficacy of Liangxue-Zhuyu decoction combined with montelukast in the treatment of henoch schonlein purpura (HSP) and its influence on immunologic function. Methods A total of 95 HSP children treated in department of pediatrics from February 2014 to December 2016 were enrolled, and then were randomly divided into observation group (n=48) and control group (n=47), meanwhile another 48 healthy children admitted to a medical examination were selected as the healthy group. The patients in the control group were given the treatment of oral montelukast sodium chewable tablets before sleeping (the dose:2-6 years old 4 mg/d, 6-14 years old 5 mg/d), and the patients in the observation group accepted the therapy of Liangxue-Zhuyu decoction based on the treatment of the control group. The course of the treatment in the two groups were 30d. The time of clinical symptom regression and adverse reactions were recorded, and the clinical efficacy was evaluated. Monoclonal antibody immunofluorescence method and Enzyme-linked immunosorbent assay (ELISA) were used to detect the levels of serum T lymphocyte subsets and INF-γ and IL-10 before and after treatment, and their differences among three groups were compared. Results The effective rates of the observation group was 95.8% (46/48), which was significantly higher than 76.6% (36/47) of control group (χ2=7.441, P<0.05). The subsided time of the symptoms, including purpura (5.0 ± 1.3 d vs. 6.6 ± 2.6 d, t=3.816), abdominal pain (3.1 ± 2.1 d vs. 4.1 ± 2.6 d, t=2.139), joint pain (4.3 ± 1.5 d vs. 5.4 ± 1.9 d, t=3.416), fecal occult blood (4.5 ± 1.5 d vs. 6.1 ± 1.9 d, t=4.404) of the observation group were significantly shorter than those of the control group (P<0.05). After the treatment, the CD4 (45.14% ± 9.32% vs. 41.02% ± 9.97%), CD8 (25.10% ± 4.69% vs. 21.52% ± 5.71%) of the observation group was significantly higher than those of the control group, and the CD4/CD8 (1.62 ± 0.32 vs. 1.95 ± 0.35) and IL-10 (33.07 ± 1.86 pg/ml vs. 53.92 ± 2.98 pg/ml) of the observation group was significantly lower than this of the control group (P<0.05). Conclusions The efficacy of the Liangxue-Zhuyu decoction combined with montelukast for HSP was definite, and the effect was rapid with little side effects. The mechanism might be related to regulating the secretion of T lymphocyte and IL-10, thereby to correct Th1/Th2 cell balance and disturbance of immune function. Key words: Purpura, schoenlein-henoch; Liangxue-Zhuyu decoction; Montelukast sodium chewable tablets; T-Lymphocytes; Interferon-gamma; Interleukin-10

The role of T cells in the development of Henoch-Schonlein purpura.

Henoch-Schonlein purpura (HSP) is an IgA-mediated disorder that most commonly occurs in children. Its etiology and pathogenesis remain unknown. In recent years, numerous studies have pointed to a dysfunction of T cells in the pathogenesis of HSP. Here, we will review the epidemiology, clinical and molecular characteristics of HSP, as well as abnormalities of Th cell subsets in this disorder. Finally, we will discuss the key factors that are involved in Th cell differentiation as potential novel targets for the prevention and treatment of HSP.

Observation on curative effect of Montelukast in treating Henoch-Schonlein purpura in children

Objective To investigate the clinical effects of Montelukast in treating Henoch-Schonlein purpura children.Methods 120 children with Henoch-Schonlein purpura were randomly divided into two groups.The control group was treated with conventional medication.The treatment group was treated with montelukast sodium (2 ～ 6 year-old given 4 mg/d,6 ～ 13 year-old given 5 mg/d,per os before sleep) in addition.The clinical effects of the two groups were compared.Results The cure rate of treatment group was obviously higher than that of the conventional group (P ＜ 0.05).The clinical effect in the control group:excellent 40 cases,utility 5 cases,ineffective 15 cases; the clinical effect in the treatment group:excellent 50 cases,utility 9 cases,ineffective 1 case.Conclusion There is a close relationship between leukotriene receptor expression in Henoch-Schonlein purpura,leukotriene receptor antagonist is effective in treatment of Henoch-Schonlein purpura,with no obvious adverse reaction. Key words: Leukotriene; Henoch-Schonlein purpura; Montelukast

Treatment of Henoch–Schönlein purpura: what evidence do we have?

The clinical features of Henoch–Schonlein purpura (HSP) are now well recognized; however, there remains uncertainty and a lack of consensus regarding treatment. Considerable concern has been expressed regarding the importance of identifying an improved, well-studied therapeutic protocol for use in the treatment of HSP. This article will focus on published studies, specifically randomized controlled trials, and aims to provide an evidence-based approach to the evaluation of therapy in children with HSP. We do have evidence that steroids do not protect against the development of kidney disease in patients with HSP. However, there is a clear lack of robust clinical trials for the treatment of moderate and severe HSP nephritis. At the present time, treatment of HSP nephritis is not guided by evidence from properly designed randomized controlled trials. We also lack consensus for the definition of outcome measures. Adequately powered, well-designed, multicenter, randomized controlled trials with follow-up peri...

Clinical analysis of Fufangzigantang in treatmem of henoch-schonlein purpura

Objective To compare the efficacy and safety of Fufangrigantang,prednisone and chlorphena-mine in the treatment of henoch-schonlein purpura. Methods 96 cases were randomly divided into two groups, con-trol group 40 cases ,taking prednisone, chlorpheniramine ;56 cases of the treatment group taking compound decoction purple,were treated for two weeks. Results In the treatment group directive rate in was 96.4%. Effective rate in the control group was 72.5% (χ2=11.41, P<0.01). Conclusion To use Fufangzigantang with other conventional drugs together is better than use prednison and chlorphenamine in the treatment of allergic purpura. Key words: Purpura,schonlein-Henoch; Predmisone; Chlorphenamine; Fufangzigantang

Henoch Schonlein Purpura in Childhood

Henoch Schonlein purpura (HSP) is one of the most common vasculitis in childhood characterized by nonthrombocytopenic purpura, abdominal pain, arthritis, and glomerulonephritis. Depending on the anatomical sites of involvement many other manifestations including every other organ of the body can be seen. However the most important involvement determining the longterm prognosis is the severity of renal disease. The pathogenesis of HSP is not clear, but it is believed to be an immunoglobulin-mediated inflammatory process resulting from immune complex reaction to various antigenic stimuli. Although none of them has been confirmed to be the exact cause, many bacterial, viral and parasitic infections, insect bites, vaccinations, and exposure to drug and dietary allergens have been described as triggering factors for HSP. Immune complexes are deposited in the vascular walls and mesangium triggering the mediators of inflammation. Treatment of HSP is supportive, and a clear advantage of glucocorticoids over supportive therapy has not been shown in the management of the disease except rapidly progressive type of glomerulonephritis. In this article the epidemiological, clinical and pathogenetic features, current treatment strategies, and outcome of the disease will be reviewed. Keywords: henoch-schonlein purpura, childhood, clinical manifestations, pathogenesis, treatment, prognosis

Henoch-Schönlein purpura

Abstract Henoch–Schonlein purpura (HSP) is the most common vasculitis of childhood with an incidence of 14–18/100 000 children per year. It predominantly affects the skin, joints, gastrointestinal tract and the kidneys but it is the renal disease which is most likely to be responsible for long-term morbidity. Treatment of HSP, particularly the nephritis, remains controversial but there is some evidence that suggests that intensive therapy may benefit those with severe disease. There is also some evidence to suggest that steroids may prevent the development of renal disease. Those with established renal disease have the potential for long-term deterioration and all of these patients warrant long-term follow-up even if the initial disease is mild.