What is allergic purpura? Do you ever experience itchy or pain in your skin, joint, or stomach? An allergy is not always attack your skin, but also other body part. Allergic purpura is allergies that occur or attack all of body part. The most common allergic purpura is allergy in skin, joint, stomach, and urinary tract.

Allergic Purpura Definition

Allergic purpura or anaphylactic purpura is non-thrombocytopenic purpura that is signed by acute or chronic allergic symptoms and vascular inflammation in skin, joint, or gastrointestinal tract, and genitourinary (GU). If allergic purpura attacked gastrointestinal tract, so this condition called Henoch-Schonlein syndrome or anaphylactic purpura. But, allergic purpura knew as sign of other conditions like nodusum erythema. Allergic purpura usually attacks for weeks and even become severe (caused by kidney problems), but almost all patient can recover from this disease.

Severe allergic purpura can be a serious disease and persistent. It can develop to chronic glomerulonephritis (it can be caused by streptococcus bacterial infection). Allergic purpura often attacks male than female and it is usually occurred in 3-7 years old children. The positive side of this condition, the prognosis is better for children than adults.

Allergic Purpura Causes

Allergy

The most common causes of allergic purpura is allergy toward many things like allergy to medicine or vaccine, insect sting, or allergy to foods like egg, wheat, milk, and chocolate. If you have an allergy toward foods, you might be feel so much pain in your stomach, diarrhea, and other gastrointestinal symptoms.

Auto Immune Reaction

Auto immune reaction means your body reacts too active toward your body part. This is a failure in immune system because it cannot recognize body part and other foreign matters. Vascular wall is the most common body part. This auto immune reaction toward vascular wall is triggered by bacteria infection, especially streptococcus.

Sign and Symptoms

Angioneurotic edema

Angioneuroticedema is swelling of lower layer of skin and tissue just under the skin or mucous membrane. The swelling usually occur in the face, tongue, larynx, abdomen, or upper and lower extremity.

The mechanism of angoneuroedema in allergic purpura typically involves histamine or bradykinin. This histamine and bradykinin are due to an allergic reaction to agents like insect bite, foods, or medicines.

Anorexia

Anorexia is an eating disorder. You might be having no appetite for a while because of stomachache, or other uncomfortable feelings.

Bleeding

Allergic purpura can cause bleeding in your body parts, especially bleeding in urinary system such as ureter mucous, bladder, or urethra. This bleeding symptom usually makes people with allergic purpura panic and afraid of it. Urine usually mixes with blood, so the urine’s color is like redness.

Glumerulonephritis

Glomerulonephritis in allergic purpura is a group of disease that injures the part of the kidney that filters blood (glomerulus). The kidney is injured if it cannot get rid of wastes and extra fluid in the body. Glomerulonephritis occurs when the glomerulus become swollen or inflamed because of allergic agents. If the illness continues, the kidney may stop working, resulting in kidney failure.
Headache

Headache is the most common symptoms of allergic purpura. Just like what we talked, allergy can injure artery wall, include head artery wall. If the allergy is occurred in head artery, headache symptoms will arise.

Henoch-Schonlein Syndrome

Henoch-Schonlein syndrome is an inflammation disease that generally attacks children under 10 years old. This is the rarest disease and it is not contagious.

The symptoms of it looked has skin eruption. This condition originally is a bleeding under skin because of blood vessels inflammation.

These symptoms usually caused by autoimmune that occurs after virus or bacterial infection.

Local edema in hand, leg, or scalp.

Allergic reaction usually look like edema or swollen in many body parts. In allergic purpura, the edema is a local edema in hand, leg, or scalp.

Fever

Fever is the symptoms for allergic purpura. This fever usually occur when the body need more white blood cells to protect the body from allergic agents inside the body.

Nephritis

Nephron is the smallest unit of kidney. Allergic purpura can cause inflammation in nephron, called nephritis. Nephritis symptoms are usually not severe in the early stages. But, kidney can be permanent damage. You have to seek medical attention if these symptoms are present; changes in urinating habits, swelling anywhere in the body, foamy urine, and blood in the urine.

Parestesia

The next symptoms of allergic purpura is parestesia. Have you ever heard about it? So parestesia is an abnormal sensation such as tingling, tickling, pricking, and numbness on one’s skin with no apparent physical causes.

This parestesia is usually painless and it occurs when the body get problems in nerves systems.

Periarticular Effusion

Periarticular means surrounding a joint. So periarticular effusion is an effusion in joints. It is an abnormal accumulation of fluid in or around a joint. Bacteria and allergic agent responsible for this fluid accumulation.

Periarticular effusion in allergic purpura easily recognized on plain x-rays. There are certain characteristics which, if seen on x-ray, are related with joint effusion. In x-ray, the joint appears as a rounded homogeneous soft tissue density with suprapatellar recess.

Pruritic

Pruritic easily means itching. But it can be associated with other disorders like dry skin. Renal

Hemorrhage

Hemorrhage is a bleeding. It can be bleeding in many parts of the body, including skin, urine, and mucous and bladder.

Rheumatoid Pain

Rheumatoid means joint. Allergic purpura can cause allergic reaction in joints, so the rheumatoid pain is usually felt by the patients.

Skin Lesion

Purple skin lesion, macula, and ecchymosis, with variant sizes and appear in symmetrical form from hand and leg. In children this lesion can spread widely and become hemorrhagic.

Diagnosis Examination

To diagnose allergic purpura, the doctors should do some diagnosis examination for better treatment.

Allergic Purpura Diagnosis

Allergic Purpura Diagnosis: rontgen

First diagnosis for allergic purpura is by anamnesis and assessments. The doctors usually refers to the sign and symptoms of allergic purpura above. If the sign and symptoms are complete and occur in patient, so the doctor will diagnose it wells. If the first diagnose does not quite approach the right diagnosis, the doctors will continue to next diagnosis examinations.

In laboratory, the doctors should do blood analysis, some results are:

  1. White blood cell count will increase and erythrocyte sediment can increase
  2. Positive in tourniquet result.
  3. Normal coagulation test result
  4. Blood urea nitrogen and creatinine serum are increase, and they will indicate kidney involvement.

Then other diagnosis will be done if the blood analysis is not show allergic purpura diagnosis. To do so, the doctors will do some diagnosis for the involvement of urinary systems like blood test in urine and feces. The blood usually positive in urine and feces.

Next diagnosis examination is small intestine x-ray to know the edema inside the small intestine. In allergic purpura, small intestine x-ray shows edema area.

Allergic Purpura Treatment

  1. Corticosteroid can be prescribed to helping out the edema of allergic purpura
  2. Analgesic can be used for abdominal and joint pain
  3. Some patient with chronic kidney failure can use immunosupression with azathioprine or corticosteroid and provocative allergen identification.

Nursing Care

  1. Support patient to maintain elimination diet as a food allergic identification so that the patient can eliminate allergic foods from his / her diet.
  2. Monitor skin lesion and assess pain scale, prescribe analgesic if needed.
  3. Assess the complication like vomit, headache, nausea, gastrointestinal bleeding, edema, hypertension (as a result of nephritis), abdominal rigidity or abdominal extenuation, and no feces.
  4. Help patient to do passive or active range of motion if the patient often lay on bed
  5. After acute stadium, tell patient about first aid if the symptoms come out and ask him / her to do urinalysis in right schedules.