Don't ignore the problems of skin ulcers and long-term wounds on your feet. The differential diagnosis of vasculitis is difficult, with various symptoms and no specificity.
Ou Canteng, an attending physician in the Department of Allergy, Immunology and Rheumatology, Zhonghe Memorial Hospital affiliated to Kaohsiung Medical University, said that vasculitis is a disease that is difficult to differentiate and diagnose because the symptoms are diverse and nonspecific. The youngest patient, like 1 seen in clinic at present, is one of the symptoms of long-term unhealed foot wounds. In addition, some patients will have symptoms such as sinusitis, nasal congestion, runny nose, or eye edema, stroke and hematuria. Some patients will feel numbness and weakness of limbs due to peripheral neuropathy, and sometimes even purple spots and rashes will appear on the skin.
Generally, when the above symptoms appear, people will intuitively seek medical treatment from otolaryngology, ophthalmology, chest, nephrology, and even dermatology and gynecology. When they go to the department of allergic immune rheumatism for the first time, they will consult the patients correctly. Usually, they will find a suitable department for diagnosis because of the pain of arthritis.
Patients with ANCA-related vasculitis will have sinusitis, stuffy nose and runny nose. There are three more serious ANCA-related vasculitis.
Vasculitis is the name of a kind of disease, because the immune system attacks vascular tissue, causing inflammation of vascular wall, leading to infiltration of inflammatory cells, thickening of vascular wall, destruction of vascular inner layer, leading to stenosis or even obstruction of vascular lumen. Vasculitis can be divided into large, medium and small vasculitis according to the size of blood vessels, and ANCA-related vasculitis involving small and medium blood vessels, including Wegener granuloma, microscopic polyangiitis and allergic granulomatous vasculitis, is more serious. This is because small blood vessels provide nutrition for the lungs, kidneys, skin and nervous system. Once an attack occurs, the symptoms are easy to be quite complicated.
Foreign studies show that ANCA-related vasculitis is common in 5 ~ 70 years old, and the incidence varies with race and region. For example, there are more white people than black people. Wegener granuloma and microscopic vasculitis are more common in southern Europe and Japan. The initial estimated incidence rate is 65,438+05 to 23 per million.
The recurrence rate of biological agents is low.
From 2005 to 2009, China's health insurance statistical research data found that the prevalence rate of Wegener's granuloma was 4/1million. According to a single center study in Taiwan Province Province, its incidence is higher than Wegener's granuloma. Dr. Ou Canteng said that vasculitis is difficult to "diagnose" and it is not difficult to treat if it can be diagnosed by the Department of Allergy and Rheumatology as soon as possible. If steroids are ineffective, and there are biological agents covered by medical insurance, not only the treatment effect is good, but also the recurrence rate is lower than that of the previous treatment, and patients can return to normal quality of life after treatment.
The doctor reminded me:
Remind the public that patients with vasculitis should not eat raw or undercooked poached eggs due to low immunity during treatment, and try to avoid going to crowded places. Remember to bring your own mask, chopsticks and spoon when you go out to avoid infection. If sinusitis, hemoptysis, hematuria, fever and other symptoms recur and the cause cannot be found, remember to ask the doctor if ANCA test is needed to prevent ANCA-related vasculitis from finding the upper body.