Additional methods of examination

Clinical blood analysis: the platelet count is usually 10-50xl0⁹/l; the blood film shows reduced numbers of platelets.

The bone marrow usually shows increased number of megakaryocytes; sensitive tests can demonstrate antiplatelet IgG either alone or with complement, on the platelet surface or in the serum in most patients.

HENOCH-SCHOENLEIN SYNDROME

The vascular disorders are a heterogeneous group of syndromes characterized by easy bruising and spontaneous bleeding from the blood vessels.

Vascular disorders resulting in abnormal hemostasis are classified into two major groups: inherited and acquired.

Henoch-Schoenlein syndrome belongs to acquired vascular disorders.

Etiology

Etiology is still unknown, but it was observed that this disease often begin after the ingestion of certain drugs or as a result of a group A streptococcal infection.

Pathogenesis

Pathogenesis may considered as hypersentivity response to the external factors with development of allergic reaction associated with acute inflammation of the small blood vessels and disorders of microcirculation, resulting in increased vascular permeability and easy bleeding.

Clinical features

This disease is most common in children, although it also may occur in adults. The abrupt onset with pain in the joints and elevated temperature arc the first features. The specific signs are the appearance on the legs and arms small pinpoint hemorrhages at the skin known as petechia accompanied with itching. The mucosa doesn’t affect in adults. During severe course of disease appear the additional points anywhere in the body with swelling and necrosis. The hematuria may be the additional sign of disease. After two weeks the lesions disappeared without skin changing.

Additional methods of examination

Clinical blood analysis: normal erythrocytes and platelets count; leucocytes count increased; regenerative nuclear shift to the left; ESR accelerated.

Literature

1. Internal diseases an introductory course. - Vasilenko V., Grebenev A. - M.: Mir . Publishers, 1990. - 647 p

2. Propedeutics to internal medicine. Part 1.-Vinnytsya: NOVA KNYHA, 2006.- 424 p.

3. Propedeutics to internal medicine. Part 2.-Vinnytsya: NOVA KNYHA, 2007.- 264 p.

4. Introduction to the course of internal diseases. Book 1. Diagnosis: [Textbook/Zh.D. Semidotskaya, O.S. Bilchenko, et al.].-Kharkiv: KSMU, 2005. -312p.

5. Michael Swash Hutchison’s clinical methods / XIX edition. ELBS, 1989. -618p.

6. Mark H., Beers M.D., Robert Berkow The Merck Manual of diagnosis and therapy / XVII edition.- Published by Merk research laboratories, 1999.- 2833 p.

7. Harrison΄s principles off internal medicine / Fauci, Braunwald, Isselbacher and al.-XIV edition. - Vol. 1 and 2. - International edition, 1998.

Topic 16. The main syndromes in leucosis. Chronic lympholeucosis and myeloleucosis.

Class lasts: 3 hours

Chronological class structure:

Control of initial standard of knowledges- 20 min.

Teacher′s demonstration of practical skills - 60 min.

Sudents′ independent work: - 30 min.

Control of ultimate standard of knowledges- 15 min.

Sum up of the class, homework- 10 min.

Questions for theoretical preparation: The definition of leucosis and their classification. The pecularities of hemopoiesis, the picture of blood and bone marrow in leucosis. Patients` basic complaints in chronic leucosis, the signs of intoxication anemic, hemorrhagic syndromes, the affection of lymphatic system and the internal organs. The main laboratory criteria of chronic myeloleucosis and lympholeucosis, the interpretation of the results of general and clinical blood test.