| Background and Objectives Allergic purpura is a kind of systemic small vasculitis whose pathogenesis is not yet clear.At present,it is believed that pathogen infection,food,drugs and so on can induce this disease,and induce the occurrence of type III allergic reaction in the body,the formation of antigen antibody complex,and inflammation around the blood vessels.The main clinical manifestations of allergic purpura were ecchymosis of lower limbs without thrombocytopenia.Psoriasis is a common immune-mediated and complex disease that is characterized by a combination of genetic and environmental factors.The disease is characterized by a thick layer of white scales covering the erythema of the skin,which can affect multiple systems of the body,such as the joints,cardiovascular,digestive and urinary systems.Adamumumab is a fully human tumor necrosis factor-α(TNF-α)blocker,which can effectively inhibit a variety of inflammatory responses involved in TNF-α.This study is through the use of a joint in patients with psoriasis Ada wood in single anti allergic purpura patients to conduct a comprehensive physical examination,laboratory and imaging examination,diagnosis and treatment,combined with the literature discuss the etiology and mechanism,improve the Ada wood sheet resistance lead to adverse reactions vasculitis,for subsequent clinical decision-making to provide some ideas.Research Objects and Methods I.Research objects A 58-year-old man presented to the doctor for "19 days of lower extremity rash,4 days worsening".II.Research methods1.Physical examination revealed petechiae and ecchymosis on the back of the patient’s lower limbs and feet.Palpation showed obvious tenderness in the abdomen,obvious tenderness in the muscles of the lower limbs,obvious tenderness in the knee joints,and slightly limited activity.2.Routine venous blood tests,such as blood routine,urine routine,stool routine,liver function,renal function,electrolyte,blood glucose,etc.,were performed on the patients on admission,and immune tests were performed to detect viral hepatitis and HIV infection,etc.3.Imaging examinations,such as abdominal radiography,plain CT scan of chest and pelvic cavity,and ultrasound of superficial mass of right upper arm,were performed on the patient.4.Gastroscopic examination and pathological examination of the descending part of duodenum were performed.5.Symptomatic supportive treatment and antiallergic treatment were given to the patients.6.Read the relevant literature,discuss the diagnosis,differential diagnosis,treatment,and possible causes and mechanisms of this adverse reaction,and deepen the understanding of vasculitis that may occur in the use of adamumumab.Results According to the clinical manifestations,physical examination,laboratory auxiliary examination,imaging auxiliary examination and histomathological biopsy before and after admission,the patient could be diagnosed as: 1.2.Articular psoriasis;3.Isolated pulmonary nodules(oblique fissure of the upper and lower lobes of the right lung);4,(upper lobe of left lung)bullae;5.Pelvic effusion;6.Erosion of the descending part of duodenum;7.Chronic non-atrophic gastritis;8.(Right)Simple renal cyst;9.Abdominal fluid.After admission to our hospital,the patient developed hematemesis and melena,and was discharged after positive anti-allergic reaction and intensive fluid replacement support treatment.Conclusion This research through the case of Ada wood single treatment resistant joints of patients with psoriasis appears allergic purpura cases studies and related literature review,has been clear about the diagnosis,discusses the TNF alpha inhibitor treatment of psoriasis occurs when vasculitis may cause and mechanism,and also discusses the TNF alpha inhibitors,paradox of vasculitis diseases and improve the process of TNF alpha inhibitors used in the understanding of the phenomenon of vasculitis,which provide a certain basis for the construction of clinical decision making. |
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