Monday, March 31, 2008

Purpura children in the differential diagnosis of nephritis

Diagnostic Classification: 1. Light: There are varying degrees of hematuria, proteinuria associated with a sexual or without proteinuria, edema and generally without hypertension, with normal renal function, the better prognosis
. 2. Acute nephritic syndrome type: for the performance of edema, hypertension and abnormal urine, and a lesser extent, oliguria not obvious. Complement without lowering blood, hematuria protracted than ordinary
Acute nephritis long. 3. Nephrotic syndrome: with the four characteristics of nephrotic syndrome, with varying degrees of hematuria. 4. Chronic renal insufficiency type: more protracted course of due Purpura Nephritis prognosis for the worst type. 5. Rapidly progressive glomerulonephritis type: rapid onset, that is, early oliguric or urine, azotemia obvious. Pathological changes of a sustained crescentic glomerulonephritis, and poor prognosis, and more
Died of renal insufficiency. See less of this type. Laboratory tests: 1. Blood: interleukin disease can be moderately higher early, and some patients eosinophilia. 2. Blood complement not low, and some early-onset patients with elevated serum IgA, and the majority of normal renal function. 3. Urine routine: varying degrees of hematuria and / or proteinuria.
Differential Diagnosis: 1. Acute glomerulonephritis: Clinical to hematuria, hypertension, edema and oliguria features seized blood Complement C3 decline. According to history and clinical characteristics, and Purpura
Nephritis it is not difficult to identify. 2.IgA nephropathy: Clinical to hematuria as the main performance, and Henoch-Schonlein Purpura Nephritis easy to confuse the two main basis differential history. 3. Lupus nephritis: clinical manifestations hematuria or proteinuria, but also for the performance of acute nephritic syndrome or nephrotic syndrome, but the involvement of kidney disease often
With multiple system involvement change, lupus seized blood cells and anti-nuclear antibody more positive. According to history and clinical manifestations generally easier to identify with Henoch-Schonlein Purpura Nephritis.

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