2014年12月21日星期日

Medication Henoch-Schonlein nephritis

Purpura nephritis, also called Henoch-Schonlein nephritis, is the behavior when aprece allergic purpura of kidney damage. Well? What caution should be exercised in patients with a drug to treat ?? If you want to know, please read next paragraph!

1. Hematuria alone or pathological stage:

Just to make proper treatment of allergic purpura, at this time there is no exact effect microscopic hematuria in the literature. We must control change the patient's condition closely, we recommend at least 3-5 years of monitoring.

2. Isolated proteinuria, hematuria, proteinuria:

Angiotensin-converting enzyme inhibitors (ACEI) and (or) angiotensin receptor blocker (ARB) class of drugs has reduced the role of proteinuria. TWP 1 mg / (kg · d), orally 3 times daily dosage does not exceed 60mg, the course of treatment is 3 months. But you should pay attention to their gastrointestinal reactions, liver damage, bone marrow suppression and possible side effects of gonadal damage,

3. The level of mild proteinuria:

Use TWP 1 mg / (kg · d), orally 3 times the maximum daily amount does not exceed 60mg, the course of treatment is 3 ~ 6 months. O combined hormonal immunosuppressant used for combined hormone example cyclophosphamide, combined with cyclosporine A or tacrolimus.

4. The nephrotic syndrome:

The group of clinical symptoms and pathological lesions were heavier now more inclined to use combined hormone immunosuppressive therapy, the more good thing is that the efficacy of corticosteroids and treatment of cyclophosphamide (CTX) .If clinical symptom is more serious, pathology showed diffuse or crescent formation lesions, can use methylprednisolone pulse therapy, 15 ~ 30mg / (kg · d) or 1000mg / (1.73 m2 · d), the maximum daily amount does not exceed 1g, every day or every two days ago, 3 time is a course of treatment.

5. Rapidly progressive glomerulonephritis or pathological IV, V - level:

This type of clinical symptom is severe, rapidly progressing now uses more therapy three or four together, usual plan is: After methylprednisolone pulse therapy treatment course 1-2, giving convinced prednisone + cyclophosphamide (or other immunosuppressive) + heparin + dipyridamole. There are still methylprednisolone pulse therapy combined urokinase + give + cyclophosphamide + prednisone convinced warfarin + dipyridamole.

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