以腹部症状为主的成人混合型过敏性紫癜1例
A Case of Adult Mixed Henoch-Schönlein Purpura Characterized by Abdominal Symptoms
DOI: 10.12677/acm.2024.14112878, PDF,   
作者: 刘 怡, 汤绍辉*：暨南大学附属第一医院消化内科，广东 广州；梁旭竞：暨南大学附属第一医院感染科，广东 广州
关键词: 过敏性紫癜；腹部症状；混合型；成人；Henoch-Schönlein Purpura； Abdominal Symptoms； Mixed； Adults
摘要: 过敏性紫癜(Henoch-Schönlein purpura, HSP)又称为IgA血管炎，是由IgA免疫复合物沉积介导的全身性小血管炎。HSP以儿童最常见，成人较为少见。临床上以皮肤紫癜最多见，可伴有关节、胃肠道及肾脏等各系统症状。当腹部症状先于紫癜出现时，易被缺乏相关经验的临床医生误诊为急腹症、急性阑尾炎、消化道出血等疾病。现报道1例以腹部症状为主的成人混合型HSP，目的在于提高临床医生对HSP的诊治水平，避免延误患者的诊治。
Abstract: Henoch-Schönlein purpura (HSP), also known as IgA vasculitis, is a systemic small vasculitis mediated by IgA immune complex deposition. HSP is most common in children and less common in adults. The most common clinical skin purpura, can be accompanied by joint, gastrointestinal and kidney and other system symptoms. When the abdominal symptoms appear before purpura, it is easy to be misdiagnosed as acute abdomen, acute appendicitis, gastrointestinal bleeding and other diseases by clinicians who lack relevant experience. A case of adult mixed HSP with abdominal symptoms was reported in order to improve the diagnosis and treatment of HSP by clinicians and avoid delay in diagnosis and treatment.
文章引用：刘怡, 梁旭竞, 汤绍辉. 以腹部症状为主的成人混合型过敏性紫癜1例[J]. 临床医学进展, 2024, 14(11): 295-301. https://doi.org/10.12677/acm.2024.14112878

参考文献

[1] Audemard-Verger, A., Pillebout, E., Guillevin, L., Thervet, E. and Terrier, B. (2015) IgA Vasculitis (Henoch-Shönlein Purpura) in Adults: Diagnostic and Therapeutic Aspects. Autoimmunity Reviews, 14, 579-585. [Google Scholar] [CrossRef] [PubMed]
[2] Song, Y., Huang, X., Yu, G., Qiao, J., Cheng, J., Wu, J., et al. (2021) Pathogenesis of IgA Vasculitis: An Up-to-Date Review. Frontiers in Immunology, 12, Article 771619. [Google Scholar] [CrossRef] [PubMed]
[3] Menon, P., Singh, S., Ahuja, N. and Winter, T.A. (2012) Gastrointestinal Manifestations of Henoch-Schoenlein Purpura. Digestive Diseases and Sciences, 58, 42-45. [Google Scholar] [CrossRef] [PubMed]
[4] Audemard-Verger, A., Pillebout, E., Baldolli, A., Gouellec, N.L., Augusto, J., Jourde-Chiche, N., et al. (2021) Impact of Aging on Phenotype and Prognosis in IgA Vasculitis. Rheumatology, 60, 4245-4251. [Google Scholar] [CrossRef] [PubMed]
[5] Van de Perre, E., Jones, R.B. and Jayne, D.R.W. (2021) IgA Vasculitis (Henoch-Schönlein Purpura): Refractory and Relapsing Disease Course in the Adult Population. Clinical Kidney Journal, 14, 1953-1960. [Google Scholar] [CrossRef] [PubMed]
[6] Zhang, Q., et al. (2013) Gastrointestinal Symptoms in Children with Henoch-Schönlein Purpura. Chinese Journal of Contemporary Pediatrics, 15, 1028-1030.
[7] Hetland, L., Susrud, K., Lindahl, K. and Bygum, A. (2017) Henoch-Schönlein Purpura: A Literature Review. Acta Dermato Venereologica, 97, 1160-1166. [Google Scholar] [CrossRef] [PubMed]
[8] 耿献辉, 等. 成人腹型过敏性紫癜误诊原因分析[J]. 临床误诊误治, 2022, 35(6): 9-12.
[9] Jithpratuck, W., Elshenawy, Y., Saleh, H., Youngberg, G., Chi, D.S. and Krishnaswamy, G. (2011) The Clinical Implications of Adult-Onset Henoch-Schonelin Purpura. Clinical and Molecular Allergy, 9, Article No. 9. [Google Scholar] [CrossRef] [PubMed]
[10] 丛春莉, 胡海清, 苏秉忠. 胃肠内镜检查在成人过敏性紫癜早期诊断中的作用[J]. 中华胃肠内镜电子杂志, 2014, 1(1): 28-30.
[11] 任万英, 李华, 赵丽婷. 过敏性紫癜在内镜下的胃、肠黏膜改变[J]. 中华消化杂志, 2002(4): 54-55.
[12] Buscatti, I.M., Casella, B.B., Aikawa, N.E., Watanabe, A., Farhat, S.C.L., Campos, L.M.A., et al. (2018) Henoch-schönlein Purpura Nephritis: Initial Risk Factors and Outcomes in a Latin American Tertiary Center. Clinical Rheumatology, 37, 1319-1324. [Google Scholar] [CrossRef] [PubMed]
[13] Koskela, M., Ylinen, E., Autio-Harmainen, H., Tokola, H., Heikkilä, P., Lohi, J., et al. (2019) Prediction of Renal Outcome in Henoch-Schönlein Nephritis Based on Biopsy Findings. Pediatric Nephrology, 35, 659-668. [Google Scholar] [CrossRef] [PubMed]
[14] Chan, H., Tang, Y., Lv, X., Zhang, G., Wang, M., Yang, H., et al. (2016) Risk Factors Associated with Renal Involvement in Childhood Henoch-Schönlein Purpura: A Meta-Analysis. PLOS ONE, 11, e0167346. [Google Scholar] [CrossRef] [PubMed]
[15] Marro, J., Williams, C., Pain, C.E. and Oni, L. (2023) A Case Series on Recurrent and Persisting IgA Vasculitis (Henoch-Schönlein Purpura) in Children. Pediatric Rheumatology, 21, Article No. 85. [Google Scholar] [CrossRef] [PubMed]
[16] Oni, L. and Sampath, S. (2019) Childhood IgA Vasculitis (Henoch-Schönlein Purpura)—Advances and Knowledge Gaps. Frontiers in Pediatrics, 7, Article 257. [Google Scholar] [CrossRef] [PubMed]
[17] Ronkainen, J., Koskimies, O., Ala-Houhala, M., Antikainen, M., Merenmies, J., Rajantie, J., et al. (2006) Early Prednisone Therapy in Henoch-Schönlein Purpura: A Randomized, Double-Blind, Placebo-Controlled Trial. The Journal of Pediatrics, 149, 241-247. [Google Scholar] [CrossRef] [PubMed]
[18] (2017) Evidence-Based Guideline for Diagnosis and Treatment of Henoch-Schönlein Purpura Nephritis. Chinese Journal of Pediatrics, 55, 647-651.
[19] Fraticelli, P., Benfaremo, D. and Gabrielli, A. (2021) Diagnosis and Management of Leukocytoclastic Vasculitis. Internal and Emergency Medicine, 16, 831-841. [Google Scholar] [CrossRef] [PubMed]
[20] Huber, A.M., King, J., McLaine, P., Klassen, T. and Pothos, M. (2004) A Randomized, Placebo-Controlled Trial of Prednisone in Early Henoch-Schönlein Purpura. BMC Medicine, 2, Article No. 7. [Google Scholar] [CrossRef] [PubMed]

为你推荐