What should I do if I have Henoch-Schönlein purpura and high urine protein?

There are many types of allergies, and a very serious one is allergic purpura. Patients will experience abdominal pain, hematuria, and skin rash. If allergic purpura occurs with high urine protein, symptomatic treatment should be given to avoid damage to kidney function.

1. Cause treatment includes eliminating pathogenic factors, controlling infection, expelling parasites, avoiding allergic foods and drugs, etc. These are fundamental measures to prevent recurrence and cure the disease. Antiparasitic treatment is possible.

2. General treatment

(1) Antihistamines: You can choose promethazine hydrochloride (Phenergan), chlorpheniramine (Chlorpheniramine), pizotifen, deschlorohydroxyzine (Clematin) or terfenadine tablets. 10% calcium gluconate can also be injected intravenously, but its efficacy is uncertain. Chlorpheniramine: 8 mg, 3 times/d, orally; Astemizole: 10 mg, 2 times/d, orally.

(2) Rutin and vitamin C: When used as auxiliary agents, the dosage should generally be large, and vitamin C is best administered by intravenous injection.

(3) Hemostatic drugs: Carbaclot (Antenosin, Anloxue) 10 mg, 2 to 3 times a day, intramuscular injection, or 40 to 60 mg added to glucose solution for intravenous drip. Ethamsulfonamide (hemostatic) 0.25-0.5g, intramuscular injection, 2-3 times/d or intravenous injection. Antifibrinolytic drugs should be used with caution in patients with renal disease.

3. Adrenal cortical hormones inhibit antigen-antibody reactions, have anti-allergic effects and improve vascular permeability. It has better efficacy on joint type, abdominal type and skin type, but hormones are ineffective for kidney damage, and some people believe that they cannot shorten the course of the disease. Generally, prednisone (prednisone) 30 mg/d is used, taken orally in divided doses. If the rash does not subside within 1 week, it can be increased to 40-60 mg/d. After the symptoms are controlled, the dosage can be gradually reduced until it is discontinued. You can also use hydrocortisone 100-200 mg/d, and switch to oral administration after the condition improves.

4. Immunosuppressants: For patients with allergic purpura complicated by nephritis, immunosuppressants may be added for those who do not respond well to hormone therapy or have prolonged illness. They are usually used in combination with hormones. Cyclophosphamide, azathioprine, etc. may be used, but attention should be paid to concurrent infections.

5. Anticoagulant therapy For cases of rapidly progressive nephritis and nephrotic syndrome, in addition to corticosteroids and cyclophosphamide (CTX), anticoagulant therapy can also be used, such as heparin 10-20U/(kg?h)×4 weeks to maintain APTt to 1.5-2.0 times the normal value.

6. To improve renal microcirculation in patients with renal impairment: 654-2 (20-30 mg/d) + ligustrazine (300 mg/d) or danshen injection, intravenous drip, 10 days as a course of treatment, 1-2 times a month.