Symptoms of purpuric nephritis, it turns out that this is how it is classified

Many people know about purpura nephritis, but few really understand it. There are many symptoms of this disease. The rash will be hemorrhagic and symmetrically distributed, the joints will be characterized by migratory polyarthritis, and there will also be symptoms of paroxysmal abdominal colic.

(1) Extrarenal symptoms include:

① Rash

Hemorrhagic and symmetrical distribution. The rash initially appears as red spots that disappear when pressed, and then gradually turns into a purple-red hemorrhagic rash that slightly raises the skin surface. The rash is often distributed symmetrically on both lower limbs, most commonly around the ankles and knee joints, and can be seen on the buttocks and upper limbs. The rash may turn yellow-brown as it subsides. In most cases, the rash may recur 1 to 2 times or up to 3 times, and in some cases it may continue for several months or even years.

② Joint symptoms

Most are characterized by migratory polyarthritis. Commonly affected joints are the knees, ankles, and hands. Symptoms usually disappear within a few days without leaving any joint deformities.

③ Gastrointestinal symptoms

The most common symptom is abdominal pain, mainly around the umbilicus and lower abdomen, with paroxysmal colic. It may be accompanied by nausea, vomiting, bloody stools, and occasionally vomiting blood. In children, intussusception, intestinal obstruction, and intestinal perforation may sometimes occur. Other symptoms include lymphadenopathy, hepatosplenomegaly, hemoptysis caused by pulmonary hemorrhage, hypertensive encephalopathy caused by nephritis, or convulsions, paralysis and coma caused by purpuric lesions of the brain.

(2) Kidney symptoms:

It is more common within 4 to 8 weeks after the onset of the rash, and in some cases several months later. It occasionally occurs before or 2 years after the rash appears. The most common manifestation is isolated hematuria. According to domestic reports, 1/4 to 1/2 of cases present with macroscopic hematuria. Proteinuria is usually mild, but it can also develop into heavy proteinuria and manifest as nephrotic syndrome. In a few cases, acute deterioration of renal function may occur. Some patients may have hypertension and edema.

2. Clinical classification of purpuric nephritis

(1) Meadow et al. classified purpuric nephritis into five types based on the clinical manifestations within three months of onset:

① Only microscopic hematuria; ② Asymptomatic proteinuria and hematuria; ③ Asymptomatic proteinuria and acute nephritic syndrome (referring to hematuria with 2 of the 3 symptoms of hypertension, azotemia and oliguria); ④ Nephrotic syndrome and hematuria; ⑤ Nephrotic syndrome and acute renal syndrome.

(2) WADs is divided into 4 types according to clinical manifestations:

① Abnormal urine output; ② Acute nephritis; ③ Nephrotic or rapidly progressive nephritis; ④ Chronic nephritis. Domestic reports have divided it into five types: ① mild or asymptomatic urine abnormalities; ② acute nephritic syndrome; ③ nephrotic syndrome; ④ chronic nephritic syndrome: ⑤ rapidly progressive nephritic syndrome. Acute nephritic syndrome is generally more common.

Warm reminder: Children have lower resistance. Sudden changes in diet, medication, and growth environment may cause discomfort to children with special physical conditions, leading to secondary infections or the culprit of purpuric nephritis in these children. However, data show that purpura nephritis has a familial tendency and may be related to genetics. The patient's family members must pay more attention and try to avoid seafood, pollen and other factors that can cause purpura nephritis.