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Objective:To compare peripheral blood tenascin-C (TN-C) level in patients with Kawasaki disease (KD) on admission, after treatment and at recovery, and to assess the potential of TN-C as a novel predictor for coronary artery lesion.Methods:Retrospective study.Blood samples of 44 KD patients [including 21 patients with coronary artery lesions (CAL + group) and 23 patients without coronary artery lesions(CAL - group)], 39 anaphylactoid purpura patients and 36 non-infected and non-vasculitis controls in the Affiliated Hospital of North Sichuan Medical College during January 1, 2018 and November 1, 2018 were collected.TN-C level was measured by enzyme-linked immunosorbent assay.Normally distributed data were compared by the t test; otherwise, they were compared by the Mann- Whitney U test. Pearson product-moment correlation coefficient or Spearman rank correlation coefficient was used to analyze the correlation between TN-C and other laboratory indexes. Results:For KD patients, TN-C levels on admission [(32.0±13.8) μg/L] and after treatment [(33.5±11.4) μg/L] were significantly higher than that at recovery [(23.3±10.8) μg/L](all P<0.01), which was positively correlated with C-reactive protein ( r=0.317, P=0.038), and negatively correlated with sodium level ( r=-0.472, P=0.004). No significant difference in TN-C level was found between CAL + group and CAL - group [on admission: (31.7±15.4) μg/L vs.(32.3±12.5) μg/L; after treatment: (32.2±11.6) μg/L vs.(34.8±11.3) μg/L; at recovery: (22.6±7.3) μg/L vs.(24.0±13.4) μg/L; all P>0.05]. In addition, TN-C level in patients with KD [(32.0±13.8) μg/L] and anaphylactoid purpura [(37.2±18.2) μg/L] was significantly higher than that of control children [(24.0±8.05) μg/L] (all P<0.01). Conclusions:The study findings are able to prove the potential of peripheral blood TN-C as a predictor for coronary artery lesion in KD patients, nor as a maker of vascular injury.Nevertheless, it may be used as an indicator of immune response in the acute phase of KD.
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Objective:To improve the effectiveness and safety of drugs and the compliance of patients with anaphylactoid purpura through the participation of clinical pharmacists in the practice of pharmaceutical treatment .Methods:In the treatment of one patient with anaphylactoid purpura , clinical pharmacists took part in the whole process and provided the individualized regimen , adverse reac-tion monitoring , relative indices monitoring and drug education after the discharge .Results:Through the participation of clinical phar-macists in the medication development , the rational use of drugs was strengthened and the treatment process was monitored .As a re-sult, the infection of the patient obtained effective control .Conclusion:The participation of clinical pharmacist in the treatment of pa-tients with anaphylactoid purpura reflects the patient-oriented pharmacy service concept , which improves the efficiency and safety of treatment.
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We herein report a 79-year-old man who developed anaphylactoid purpura after thoracic endovascular aortic repair, which he underwent for a distal aortic arch aneurysm of saccular type. On the third postoperative day he had purpura over his lower legs and abdomen accompanied by intermittent fever. His serum C-reactive protein concentration reached a maximum of 12 mg/dl, and remained at around 4 mg/dl thereafter. A dermatologist diagnosed anaphylactoid purpura ; this gradually improved with topical steroid and the nature and dosage of the oral medication. We suspected the presence of malignancy ; however, appropriate investigations failed to identify a cause for the purpura. During 6 months of outpatient follow up he has been free of recurrence. Anaphylactoid purpura occurs most frequently in childhood, often after an upper respiratory tract infection, whereas this condition is rare in adults. Triggers for anaphylactoid purpura include surgery, infection, certain medications, chronic lung, liver, or renal failure, and malignancy. We believe that the stress of undergoing thoracic endovascular aortic repair was the trigger in this case. Anaphylactoid purpura may be complicated by arthritis, gastrointestinal involvement and renal manifestations. There were no such complications in this case.
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Objective:To evaluate the roles of imbalance between peripheral blood T helper17(Th17) cells and CD4+CD25+regulatory T(Treg) cells in the pathogenesis of Anaphylactoid purpura(AP).Methods: Peripheral blood samples were obtained from fifty-two patients with AP and thirty age-and sex-matched healthy controls.The percentage of Th17 cells and Treg cells in peripheral blood were detected with Flow cytometry.Furthermore,the serum level of IL-6,IL-17,IL-22 and IL-23 and transforming growth factor (TGF)-βand IL-10 were detected with the use of enzyme linked immunosorbent assay(ELISA).Results: In comparison with the controls,the AP children showed a higher percentage of Th17 cells and an increased serum level of IL-6,IL-17,IL-22 and IL-23(P<0.05),but the percentage of Treg cells and the serum level of TGF-βand IL-10 were significantly lower in AP group(P<0.05).Con-clusion:AP children experience a change in the percentage of peripheral blood T helper17 cells and CD4+CD25+regulatory T cells in peripheral blood.The imbalance between the Th17 cells and Treg cells in peripheral blood may contribute to the development of Ana-phylactoid purpura.
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Objective To observe the effect of treating infantile anaphylactoid purpura with self-made Huoxue Huayu decoction. Methods 68 cases with infantile anaphylactoid purpura ,were randomly recruited into a control group and a treatment group, with 34 cases in each group. The control group was taken Cetirizine, Prednisone, Rutin and Vitamin C orally. The treatment group was treated with self-made Huoxue Huayu decoction on the basis of treatment in the control group. Results The total effective rate of the control group and the treatment group was 82.35% and 94.12% respectively. As compared with the effective rate in the control group, the treatment group showed significant improvement. Conclusion It was effective to treat infantile anaphylaetoid purpura with Huoxue Huayu decoction.
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Objective To observe the curative effect about heavy abdomen type of anaphylactoid pur-pura treated by Methylprednisolone associate with Heparin. Methods Randomly divided eighty three children with heavy abdomen type of anaphylactoid purpura who treated in department of pediatrics of the first hospital affiliated to Kunming medical college from January, 2006 to december, 2007 into group A (treated by Hydro-cortisone) and group B (treated by Methylprednisolone) and group C(treated by Methylprednisolone associate with Heparin). Group A treated by mainline Hydrocortisone dose of 5～8 mg/kg body weight once a day,mixed into 100ml 5% glucose injection, after 7～14 days later, instead of take orally Predisone tablet and de-grees dose by gradually. Group B treated by mainline Methylprednisolone dose of 2～4 mg/kg body weight once a day, mixed into 100ml 5% glucose injection, after 7～14 days later, instead of take orally Predisone tablet, and group C treated by Methylprednisolone by oneself (dose like group B) associate with mainline Hep-arin (dose of 0.25～0.75 mg/kg body weight once a day, mixed into 100ml 5% glucose injection) 7～10 days. Observe clinic symptomatic like as tetter, bellyache, entron hemorrhage when treatment of every group. Contrast reiteration rate of anaphylaetoid purpura, and the period of urine test get hack normal which cases with kidney tamper. Contrast these medication' s side effect such as resort of natrium and water, elec-trolyte turbulence, hemorrhage and so on. Results Group C (treated by Methylprednisolone associate with Heparin) is better then group A (treated by Hydrocortisone) and group B (treated by Methylprednisolone by oneself) in eliminate tetrer and release bellyache. The less period of group C need to treatment entron hemor-rhage and urine test get hack normal. And thereiteration rate is less of group C than group A and group B.Conclusion Methylprednisolone in association with Heparin to treat heavy abdomen type of anaphylactoid purpura is better than hydrocortisone and Methylprednisolone by oneself in controling symptom, reduing reiter-ation rate and more less side effect. So methylprednisolone in association with Heparin to treat of heavy ab-domen type of anaphylactoid purpura is a ideal project.
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A case of a 4-year old Filipino female with anaphylactoid purpura complicated by cutaneous necrosis and gangrene was herein reported. Therapy with 6% Dextran infusions was dramatic and rewarding as evidenced by cessation of further progression of the ischemic lesions and the eventual drying up of almost all cutaneous manifestations. Mention was made of the extreme rarity of the present case as attested by only a few cases so far reported in the literature. (Summary)