The Causes of Purpura Nephritis
As many of us know, the pathological changes of Purpura Nephritis are the
desmoid necrosis of capillary and arteriole walls, the exudation of seriflux
around vessels and the infiltration of inflammatory cells. The above
pathological changes may occur in skins as well as in heart, lung, liver and
vessels in head, which can result in damage and bleeding of organs. We should
know that renal pathological change is a major part of that of Purpura
Nephritis. For patients with mild illness condition, they may present focal
lesions in the kidney and proteinuria. With the development of the disease,
diffuse proliferative pathological changes will appear in glomerular capillary
basilar membrane. When the disease attacks, there will be sedimentations of
massive fibrin, IgG, IgA and C3 at glomerular basilar membrane and cementins,
and patients may show renal insufficiency. If the disease develops into a
serious degree, glomerular capillaries will present focal necrosis and platelet
thrombus, the renal tubular epithelial cells will become swelling and the lumen
may get blocked.
The Clinical Manifestations of Purpura Nephritis
1. Manifestations out of the kidney. About half of the patients may get the
infection of upper respiratory tract 1 to 3 weeks before the onset. Almost all
the patients will present characteristic symmetric hemorrhagic rash which looks
like urticaria at the beginning and gradually grows into spot-like purpura which
is higher than the skin, commonly appears at the extensor side of legs and hip
and may repeatedly arise within several months. 60% of the patients have
abdominal pain and hematochezia; 30% of them suffer from pains in joints
especially in knee and ankle. For some patients, renal impairments follow the
appearance of rash; and for adult patients, systemic manifestations like
gastrointestinal symptoms are not obvious.
2. Manifestations of renal impairment. About 40% of the patients have
glomerular damage which commonly appears 8 weeks after the onset of Purpura
while some may occur 2 years later and even arise before the appearance of rash.
The main clinical manifestation of Purpura Nephritis is hematuria sometimes
together with slight proteinuria.
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