Pediatric emergency medicine trisk 2897 2897
Bạn đang xem bản rút gọn của tài liệu. Xem và tải ngay bản đầy đủ của tài liệu tại đây (130.65 KB, 1 trang )
several weeks. Gross hematuria will diminish rapidly, though microscopic
hematuria may persist for 6 months or longer. Proteinuria typically
improves quickly and resolves within 6 months, although some patients
may have mild proteinuria years after the initial illness. Studies evaluating
the long-term prognosis reveal residual signs of chronic kidney damage in
some patients decades after the initial course. This underscores the
importance of routine monitoring of blood pressure and urinalyses as part of
health maintenance in those who have a history of APSGN.
Henoch–Schönlein Purpura
Goals of Treatment
The goals of treatment for Henoch–Schönlein purpura (HSP) are generally
supportive. Analgesics and anti-inflammatory medications such as NSAIDs
may help alleviate associated arthralgias and arthritis. Patients may require
parenteral hydration, especially in the setting of gastrointestinal
manifestations. Children with abdominal pain should be evaluated and
monitored for surgical complications (see Chapter 53 Pain: Abdomen ).
HSP-associated nephritis rarely requires specific interventions. If there is
concern for significant AKI, a nephrologist should be consulted to help
determine further evaluation and management.
CLINICAL PEARLS AND PITFALLS
Nephritis secondary to HSP most often presents within the first 4
weeks but may present up to 6 months after the initial
presentation of rash and arthritis.
Patients with suspected HSP should undergo urinalysis to
evaluate for hematuria.
Care is generally supportive.
Clinical Considerations
Clinical recognition. Immunoglobulin A vasculitis, more commonly known
as HSP, is an IgA-mediated multisystem small-vessel vasculitis
predominantly affecting the skin, joints, gastrointestinal tract, and kidneys.
Though HSP can occur at any age, most cases affect children between 3 and
