What should I do if Henoch-Schönlein purpura recurs?

Allergic purpura mostly occurs in teenagers and children. At the beginning, there will be general discomfort, fever, joint pain, headache and other symptoms. Generally, the recurrence of this disease is caused by triggers, so you must pay more attention to it in normal times, pay more attention to rest, pay attention to nutrition, and use drugs for treatment when it relapses.

1. Etiological treatment: Actively seek and treat possible causes. It is difficult to find an obvious cause for the vast majority of allergic purpura, and it is easy to relapse and difficult to cure completely. Simple skin purpura is mainly treated with rest and should not be excessively treated with drugs. 2. Generally, patients should rest in bed during the acute phase of treatment. Pay attention to fluid intake and output, strengthen nutrition, and maintain electrolyte balance. When gastrointestinal bleeding only manifests as positive occult blood in the stool and the abdominal pain is not severe, liquid food can be used. Patients with severe gastrointestinal bleeding should fast. Be careful to find and avoid contact with allergens. For symptomatic treatment, those with fever and joint pain can use antipyretic analgesics such as indomethacin and ibuprofen; those with abdominal pain can use antispasmodics such as scopolamine orally or intramuscularly, or atropine intramuscularly; if there is obvious infection, give effective antibiotics.

3. Antihistamines are suitable for simple purpura, and rutin, vitamin C, calcium supplements, anloxin or hemostatics can be used at the same time. When there is urticaria or angioneurotic edema, antihistamines and calcium supplements should be used; in recent years, the H2 receptor blocker cimetidine has been proposed for treatment. 4. Take the antiplatelet drug aspirin orally once a day; take dipyridamole in divided doses. 5. Anticoagulant treatment: This disease may present with fibrinogen deposition, platelet deposition and intravascular coagulation, so in recent years heparin or urokinase has been used for treatment.

6. Adrenal cortical hormones are suitable for severe skin lesions or articular, abdominal, and renal purpura. Indications for the use of hormones: (1) Severe gastrointestinal lesions, such as gastrointestinal bleeding, can be treated with oral prednisone in divided doses, or with dexamethasone or methylprednisolone, which can be discontinued after symptoms are relieved; (2) Patients with nephrotic syndrome can use prednisone for no less than 8 weeks; (3) Rapidly progressive nephritis can be treated with methylprednisolone pulse therapy, with the same dose as lupus nephritis. If hormone therapy is ineffective, immunosuppressants such as cyclophosphamide can be added. 7. Plasma exchange can effectively remove immune complexes in the blood circulation, thereby preventing vascular obstruction and infarction. It is suitable for patients with severe abdominal and renal types with large amounts of immune complexes in their plasma. 8. For other severe cases, large doses of immunoglobulin shock therapy can be used.

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