Patient: description of the condition (onset time, main symptoms, hospital, etc.): the child allergic purpura 45 days, during the drink of Chinese medicine, and the blue and purple, pavement blue, fishy grass, vitamins, rutin October 9, the first time the red spots 4.5 days on the retreat, October 25, the lower extremities again full of red spots, has been drinking medicine, until now also did not retreat clean or traces, today there are more than a green bean Today there are many red dots the size of green beans, no meat, eggs or milk has been added, and the urine test is normal. The original is so long there are still traces of it is normal? The actual fact is that you can find a lot of medicines and still have a lot of them. How can I prevent it? What about the small dots that often arise? According to the current situation, when can I add meat, eggs and milk? When will it be cured before I can stop taking the medicine? Thank you for your guidance! The second hospital of Shandong University, Department of Pediatrics, Liu Fang’e: the pathogenesis of allergic purpura pathogenesis is complex, itself has a tendency to recur. A variety of triggers can contribute to the recurrence of the disease. The reason for your child’s recurring rash may be related to his or her exposure to one or more factors in his or her living environment, but of course we can’t tell the exact cause. However, if your child has a recurrent rash, there is no need to be too nervous. There is no specific treatment for the rash. However, the recurring rash suggests disease activity and a tendency to kidney damage, also known as purpura nephritis, which is a tricky disease. Suggestions: 1. Be sure to avoid suspicious triggers. You can see my article — [Allergic purpura] 2, regular recheck urine routine. If there are still doubts, it is recommended to go to a regular hospital to see a pediatric nephrologist. Wish your child a speedy recovery. Patient: Thank you Professor Liu! Thank you very much for your guidance at the most confusing time for me! So you see, according to the current situation, the urine test is normal, only in the calf there are a number of relatively small red spots, how long do I need to continue to take medication? How long will it take to heal? How long will it take for the urinalysis to be fine so that there are no complications? Is it true that as long as there are red spots, I cannot add meat, eggs and milk? I would like to ask for your guidance! I wish you all the best! Thank you! Patient: Hello, Professor Liu! My child had a urine microscopy today with 2 red blood cells and negative occult blood, do you think it indicates a kidney problem? I’m so nervous. I’ll check again this afternoon to see. The second hospital of Shandong University, Department of Pediatrics, Liu Fang’e: In the course of allergic purpura (mostly within 6 months), the appearance of hematuria and/or proteinuria is called purpura nephritis. The repeated appearance of the rash indicates disease activity, and can foods and other can factors should be avoided. Clinical typing of allergic purpura: 1, isolated hematuria or isolated proteinuria. 2, hematuria and proteinuria. 3.Acute nephritis type. 4.Nephrotic syndrome type. 5.Acute nephritis type. 6.Chronic nephritis type. Hematuria is defined as ≥3 red blood cells per high-powered field of view in urine and >5 red blood cells per high-powered field of view in centrifugal urine. 2 red blood cells on microscopic examination and negative occult blood in the child have not yet reached the standard of hematuria. I wish the child a speedy recovery. Patient: Thank you Professor Liu! I checked a stool in the afternoon and it was fine. In the morning, there were only a few small spots, but tonight there are many spots of different sizes on the calf again, and it looks a little swollen, is this a recurrence? Is this the case? What should we do? My child’s throat has been a little red and swollen lately, and I didn’t participate in gym class this afternoon, but I stayed on campus for a class. This is the third time, and it’s been more than a month, so I don’t know what to do. Now I only dare to eat green vegetables and drink medicine all the time, how long does it take to get better? How can I avoid kidney damage? I look forward to your guidance in your busy schedule! Thank you! I wish you a good life! The Second Hospital of Shandong University, Department of Pediatrics, Liu Fang’e: Measures to prevent recurrence of the disease: remove possible allergens, avoid strain, pay attention to warmth, avoid mood swings, prevent insect bites, avoid the application of drugs that may cause allergies. Forbid eating raw onion, raw garlic, chili, alcohol and other irritating foods; temporarily forbid meat, seafood, eggs, milk, etc., drinks, snacks and other convenience foods. Pay attention to avoid eating foods that are rough, hard and mechanically stimulating to the gastrointestinal tract. Does your child have a sore throat and a respiratory tract infection? Is he or she exposed to allergic factors at school? It is recommended to go to the hospital to see a specialist. The rash has been recurring recently and it is advisable to rest at home for a few days. I look forward to your child’s recovery soon. Patient: Thank you very much, Professor Liu! It’s so late and you are still replying to us, you have worked hard! I didn’t eat any of the things you mentioned above, I only ate green vegetables, tomatoes and potatoes, can I eat them? Is it true that you can’t eat soy products first? What about bean curd or something like that? The child used to have tonsillitis, and this time too, do you think it is related? Do you see any other good treatment plan? I also know the most fear of kidney damage, what can be done? According to your experience, how long does it take for the chance of kidney damage to decrease? I thought it is a self-limiting disease if there are no complications, is there a possibility of healing and how long does it take? The family appreciates your efforts! Thank you! I wish you all the best! The second hospital of Shandong University, Department of Pediatrics, Liu Fang’e: Although this disease is called “allergic” purpura, but it is difficult to find out what kind of things are allergic to, general green vegetables are allergic to few, tomatoes, potatoes, beans can try to eat, homemade soy milk can also try to eat. Generally milk, eggs and seafood are the foods that have caused allergies. The principle of adding food is generally to add one kind of food first, observe for about a week, and then add another kind of food after the condition does not recur. However, it should be noted that it is best not to add soy sauce, MSG and other things whose ingredients are not completely clear, because it is not known whether they contain seafood, condiments, etc. Inflammation of the tonsils can cause recurrence of the disease. Get a doctor to look at it and deal with it accordingly. This disease has a tendency to recur, and there is no special method to prevent recurrence. There is no specific treatment available to prevent kidney damage. If no kidney damage occurs within 6 months of the disease, the prognosis should be good and the chance of kidney damage in the future is much less, but it is not absolute. If the kidneys are not involved, the disease is self-limiting. But purpura nephritis is a tricky disease. You are welcome. I hope your child will recover soon. Patient: Thank you for your enthusiastic answer, thank you very much! You are the only one who is so attentive after asking many doctors, you are really admirable! I thank you on behalf of my family! It’s a pity that I can only ask you for the last time! I only know that this disease is very troublesome, I did not expect so many things, my heart is not sure, in addition to abstain from drinking medicine, only patience is left, I take your good advice hope that the child will recover soon. This morning, I checked the urine without red blood cells, so I was a little relieved, but I was still worried when I saw the red spots on my legs! Professor Liu, there are so many causes of this disease, how should we treat it? Is it just a guess? Is there a diagnostic test? I saw that someone checked the allergen but the doctor said it doesn’t mean that I can’t eat it, and I wasn’t allergic to it before. What should I do in the end? Professor Liu, what is the principle of treatment for this disease in your clinic? How long does it usually take to treat this kind of skin disease? I look forward to your guidance again. I wish you a good life! The Second Hospital of Shandong University, Department of Pediatrics, Liu Fang’e: Please do not be polite. I just hope you can read my reply carefully, because I found that some of the problems I have explained need to be explained once again. Our body’s immune system is like the body’s “guard”, once there are exogenous germs, inhalation of suspicious substances, eating suspicious food or skin contact with a substance, that is, this disease so many so-called “cause” invasion, they are like the body’s “Our immune system will react to them, and the body will fight back, the purpose is of course to remove the “enemy”, but the results of the war sometimes also accidentally injured “civilians”, that is, our normal cells, tissues, and tissues. Sometimes the immune system will also directly treat the “civilians” as “invaders”, which causes our disease to occur. The allergic purpura happens like the above analogy, no matter what causes triggered it in the first place, but the result is that while removing these factors, its own blood vessels are mistakenly injured and inflammation occurs, thus causing a series of symptoms. Therefore, treatment only for the cause cannot completely prevent the occurrence and development of the disease. There is no effective etiological treatment. The name of allergic purpura itself is easily misunderstood, thinking that it is caused by an allergy to a certain substance, but often the allergen is difficult to identify, basically can not find out what factors are allergic to, so allergen detection is not very meaningful, only to avoid the common suspected allergens. It is possible that you may be allergic to something you were not allergic to before, but now you are not allergic to it again after recovering from the disease, because there is a “mistake” in the immune system of the body. Therefore, if you are allergic to a certain food during the disease, you should not eat it for the time being. Allergic purpura treatment principle: no special treatment. It is possible to give symptomatic treatment such as anti-allergy, complete removal of infection and relief of symptoms. Due to the physical condition, patients with allergic purpura are susceptible to environmental changes, such as cold weather, exertion, mood swings, cold, diet, etc. causing aggravation and recurrence of symptoms. The existing treatment methods sometimes cannot prevent the recurrence of the disease and kidney damage. If you can’t do to effectively avoid can factors, skin purpura may recur again and again. I wish my child a speedy recovery from the disease.